Selva KABUL, Havva Merve DİNÇ, Mine ÖZŞEN
Kocaeli Üniversitesi Sağlık Bilimleri Dergisi - 2026;12(3):277-281
Objective: Endometrioid endometrial carcinoma (EEC) generally has a favorable prognosis, yet some cases exhibit aggressive behavior unexplained by standard parameters. Although p53 immunohistochemistry (IHC) primarily serves as a surrogate for TP53 mutations, quantitative variation within the wild-type (wt) category may hold prognostic value. This study investigated whether the proportion of p53-positive tumor cells correlates with established prognostic parameters in p53-wt EEC. Methods: Eighty-eight p53-wt EEC hysterectomy specimens (2022-2024) were retrospectively analyzed. Two pathologists independently evaluated p53 nuclear positivity percentages. Clinicopathological data, including grade, tumor size, myometrial invasion, cervical involvement, lymphovascular invasion (LVI), and microsatellite instability (MSI) status, were analyzed. An optimal cutoff for p53 expression was determined via Receiver Operating Characteristic (ROC) analysis. Results: p53 positivity ranged from 1% to 90%. ROC analysis identified a 4% cutoff, stratifying cases into low (<=4%, n=36) and high (> 4%, n=52) expression groups. High p53 expression was significantly associated with LVI (p=0.0049), higher tumor grade (p<0.0001), and MSI-high status (p=0.0064). No significant associations were found with tumor size, myometrial invasion depth, or cervical involvement. Conclusion: In p53-wt EEC, higher p53 expression correlates with adverse clinicopathological features. Quantitative p53 IHC assessment may identify biologically distinct subgroups and provide complementary prognostic information in routine practice.
