HER2 Immunohistochemical Expression and p53 Patterns in Endometrial Carcinoma: Associations with Clinicopathological Features in Iraqi Women
DOI:
https://doi.org/10.46966/msjar.v7i3.456Keywords:
Background: HER2 has emerged as a treatment-relevant biomarker in selected endometrial carcinomas. However, data on HER2 expression across histotypes, and its relationship with p53 status, are limited from the Middle East. We assessed HER2 and p53 immunohistochemistry in endometrial carcinomas from Iraq. Methods: This retrospective cross-sectional study, conducted at [n] centers in Karbala, Iraq, included 38 formalin-fixed paraffin-embedded endometrial carcinomas diagnosed between January 2024 and February 2025: 32 endometrioid carcinomas, four serous carcinomas and two carcinosarcomas. HER2 membranous staining was scored as 0, 1 , 2 or 3 according to [criteria]. p53 was classified as wild-type or abnormal (overexpression, null or cytoplasmic pattern). Proportions are reported with Wilson 95% confidence intervals (CIs). Group differences were tested with two-sided Fisher exact or Fisher-Freeman-Halton tests because of sparse cells. Results: HER2 was scored 0 in 25 cases (65.8%), 1 in three (7.9%), 2 in seven (18.4%) and 3 in three (7.9%; 95% CI 2.7–20.8%). Ten tumors (26.3%; 95% CI 15.0–42.0%) showed HER2 2 or 3 . Nineteen tumors (50.0%; 95% CI 34.8–65.2%) had abnormal p53 staining. The HER2 score distribution did not differ by p53 status (P = 0.722). All six non-endometrioid tumors were p53-abnormal, compared with 13 of 32 endometrioid tumors (40.6%; P = 0.020). HER2 2 /3 was seen in three of four serous carcinomas, one of two carcinosarcomas and six of 32 endometrioid carcinomas (exploratory P = 0.031). Conclusions: In this Iraqi series, HER2 3 staining was uncommon, while 2 staining was more frequent. HER2 score was not associated with p53 status. Abnormal p53 was present in all non-endometrioid carcinomas and in a substantial proportion of endometrioid carcinomas. HER2 2 /3 appeared more frequent in non-endometrioid histotypes, but the small subgroups mean larger studies with ISH confirmation are needed. Keywords: endometrial carcinoma; HER2; ERBB2; p53; TP53; immunohistochemistry; Iraq.Abstract
Background: HER2 has emerged as a treatment-relevant biomarker in selected endometrial carcinomas. However, data on HER2 expression across histotypes, and its relationship with p53 status, are limited from the Middle East. We assessed HER2 and p53 immunohistochemistry in endometrial carcinomas from Iraq. Methods: This retrospective cross-sectional study, conducted at [n] centers in Karbala, Iraq, included 38 formalin-fixed paraffin-embedded endometrial carcinomas diagnosed between January 2024 and February 2025: 32 endometrioid carcinomas, four serous carcinomas and two carcinosarcomas. HER2 membranous staining was scored as 0, 1+, 2+ or 3+ according to [criteria]. p53 was classified as wild-type or abnormal (overexpression, null or cytoplasmic pattern). Proportions are reported with Wilson 95% confidence intervals (CIs). Group differences were tested with two-sided Fisher exact or Fisher-Freeman-Halton tests because of sparse cells. Results: HER2 was scored 0 in 25 cases (65.8%), 1+ in three (7.9%), 2+ in seven (18.4%) and 3+ in three (7.9%; 95% CI 2.7–20.8%). Ten tumors (26.3%; 95% CI 15.0–42.0%) showed HER2 2+ or 3+. Nineteen tumors (50.0%; 95% CI 34.8–65.2%) had abnormal p53 staining. The HER2 score distribution did not differ by p53 status (P = 0.722). All six non-endometrioid tumors were p53-abnormal, compared with 13 of 32 endometrioid tumors (40.6%; P = 0.020). HER2 2+/3+ was seen in three of four serous carcinomas, one of two carcinosarcomas and six of 32 endometrioid carcinomas (exploratory P = 0.031). Conclusions: In this Iraqi series, HER2 3+ staining was uncommon, while 2+ staining was more frequent. HER2 score was not associated with p53 status. Abnormal p53 was present in all non-endometrioid carcinomas and in a substantial proportion of endometrioid carcinomas. HER2 2+/3+ appeared more frequent in non-endometrioid histotypes, but the small subgroups mean larger studies with ISH confirmation are needed.
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Copyright (c) 2026 Haneen Mohammad Ali Abbod, Mohammad Fawzi Alqanbar, Shaima Jabbar
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