Immunos and Molecular

WHAT ARE TUMOR CELLS THINKING?

Should we use immunos and molecular to find out what are cells doing, or what are they thinking?

An endometrial endometrioid adenocarcinoma, grade 1, positive for ER and with a wild-type p53 is what should be expected.

An endometrial endometrioid adenocarcinoma, grade 1, negative for ER and with a diffusely positive reaction for p53 probably means that this endometrioid adenocarcinoma is thinking about becoming a serous carcinoma. You will always find a someone who will try to convince you that there is some atypia and in reality, it is a serous carcinoma. But we are all familiar with cases where we get a p53 because there are some atypical glands in the endometrium and then, over 50% of the glands are very positive, most of them obviously endometrioid.

It is not a problem to sign out the case, long comments are not difficult to render. However, the important issue is how the patient should be treated. Should a patient with an obvious endometrioid adenocarcinoma but which is negative for ER and positive for p53 be treated as having a low-grade endometrioid adenocarcinoma, or as having a serous carcinoma?

We will have the answer to this question after several studies of a large number of these cases demonstrate that these tumors either behave like low-grade endometrioid cases or as high-grade serous carcinoma. In the meantime, I think we should use common sense.

Many of us are thinking many things but in the end what we do can be totally different. If we were going to be judged by what we are thinking, many of us would be in jail or in an institution ( at least I would be).