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OBJECTIVE The aim of this study was to analyze the value of epithelial membrane antigen (EMA) overexpression in benign and malignant endometrium and its prognostic significance. METHODS EMA immunostaining was performed in 178 paraffin-embedded specimens including 105 endometrial cancers, 40 endometrial hyperplasias, and 33 benign endometriums. EMA immunostaining was correlated with traditional prognostic factors and progression-free survival in endometrial cancer specimens. RESULTS EMA overexpression was observed more frequently in adenocarcinomas (60%) than in hyperplasias (15%) or benign endometrium (9.1%). EMA overexpression was observed in two patients with endometrial hyperplasia who progressed to carcinoma. In adenocarcinomas, EMA overexpression had a positive correlation with nonendometrioid subtypes (P = 0.012). In multivariate analysis, FIGO stage (P = 0.025) and EMA overexpression (P = 0.017) were independent prognostic factors for progression-free survival. CONCLUSIONS EMA overexpression appears to be a marker of malignant transformation in the endometrium and it is an independent predictor of recurrent disease in endometrial cancer.
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