1. Clinicopathologic studies of mixed tumors of the endometrium

I have investigated the epigenomics of uterine carcinosarcoma (malignant mixed Mullerian tumor, MMMT) (collaboration with Ting Wang, PhD) with the goal of discovering molecular genetic mechanisms that explain the unique phenotype of these aggressive tumors. Whereas most uterine tumors are relatively monomorphic, carcinosarcomas by definition display a range of phenotypes within a single patient, including at a minimum a component of carcinoma and a component of sarcoma. The molecular lesions underlying this variability have not been determined. Initial studies indicated the differential methylation of several oncogenes in these tumors, including aberrant methylation of the MIR200 locus which may contribute to epithelial-mesenchymal transition.

In separate work, I am responsible for the analysis phase of GOG-8032, a subprotocol of Gynecologic Oncology Group trial GOG-210 that provided expert histologic annotation of 3,566 uterine tumors enriched for high-risk types. This data set permits detailed examination of the pattern of presentation, stage and outcome of several tumor types that have not been extensively discussed in the literature, including mixed and indeterminate serous and clear cell cancers.

2. Research pathology services and collaborations

I provide research pathology services to a wide variety of collaborators at Washington University and elsewhere. Together with imaging scientists at WU, I am working toward validation of novel biomedical imaging technologies including ultrasound-guided optical tomography and photoacoustic imaging as applied to breast and ovarian cancer detection (Quing Zhu, PhD) and diffusion-based spectral imaging as applied to placental inflammation (Yong Wang, PhD). I am supporting a trial of RANK inhibition for primary prevention of breast cancer (Tunji Toriola, MD, PhD), was one of the study pathologists for the ALTERNATE trial (Matthew Ellis, MD, PhD, Cynthia Ma, MD, PhD), and am developing methods for Ki-67 ascertainment by image analysis for clinical and research purposes.

3. Tissue core services for the Route 66 Endometrial Cancer SPORE

I am the co-director of the Biospecimen, Metabolomics and Pathology (BMP) Core in the Route 66 SPORE in Endometrial Cancer, funded in 2023 by an NCI award to our consortium of Washington University, the University of Oklahoma, the University of New Mexico, and the University of California--San Francisco. The BMP Core, co-directed with Mark Watson, MD, PhD, Department of Pathology, and Gary Patti, PhD, Department of Chemistry, will be essential to the successful execution of the projects within this SPORE, providing high-quality, clinically annotated biospecimens, metabolomics analyses, and expert pathology review. 

Gynecologic diseases, breast diseases, molecular (DNA-based) testing.

• Information for Patients