Citation Information :
Lakhani A, Wani RV, Pilli GS. Expression of PTEN Marker in Endometrial Hyperplasia without Atypia: One-year Observational Study. J South Asian Feder Obs Gynae 2023; 15 (1):1-4.
Aim: To evaluate phosphatase and tensin homolog (PTEN) expression in endometrial hyperplasia without atypia.
Materials and methods: Sixty paraffin-embedded blocks with endometrial hyperplasia without atypia histopathology were obtained. Immunohistochemical staining with PTEN antibody was done and was evaluated for staining intensity and proportion score.
Results: The study population consisted of a total of 60 cases of endometrial hyperplasia without atypia. 52 cases had (86.70%) simple hyperplasia and 8 cases (13.30%) had complex hyperplasia. Out of the total 60 cases, only 2 cases of complex hyperplasia showed negative staining depicting the loss of PTEN. The correlation of endometrial hyperplasia with color intensity and proportion score was highly significant (p-value = 0.001).
Conclusion: Phosphatase and tensin homolog expression is seldom lost in cases of endometrial hyperplasia without atypia, and if seen, needs closer monitoring to evaluate for atypia and endometrial carcinoma.
Clinical significance: We propose that endometrial hyperplasia without atypia with loss of PTEN should be closely followed up to assess for atypia or carcinoma.
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020; GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209–249. DOI: 10.3322/caac.21660.
Lortet-Tieulent J, Ferlay J, Bray F, et al. International patterns and trends in endometrial cancer incidence, 1978–2013. J Natl Cancer Inst 2018;110(4):354–361. DOI: 10.1093/jnci/djx214.
Kurman RJ, Carcangiu ML, Herrington CS, et al., editors. WHO Classification of Tumours of the Female Reproductive Organs. 4th ed., Lyon: IARC; 2014.
Rotenberg O, Fridman D, Doulaveris G, et al. Long-term outcome of postmenopausal women with non-atypical endometrial hyperplasia on endometrial sampling. Ultrasound Obstet Gynecol 2020;55(4):546–551. DOI: 10.1002/uog.20421.
Lacey JV Jr, Sherman ME, Rush BB, et al. Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia. J Clin Oncol 2010;28(5):788–792. DOI: 10.1200/JCO.2009. 24.1315.
Watanabe T, Nanamiya H, Kojima M, et al. Clinical relevance of oncogenic driver mutations identified in endometrial carcinoma. Transl Oncol 2021;14(3):101010. DOI: 10.1016/j.tranon.2021.101010.
Steinbakk A, Gudlaugsson E, Aasprong OG, et al. Molecular biomarkers in endometrial hyperplasias predict cancer progression. Am J Obstet Gynecol 2011;204(4):357.e1–357.e12. DOI: 10.1016/j.ajog.2010.12.007.
Mutter GL, Lin MC, Fitzgerald JT, et al. Altered PTEN expression as a diagnostic marker for the earliest endometrial precancers. J Natl Cancer Inst 2000;92(11):924–930. DOI: 10.1093/jnci/92.11.924.
Kapucuoglu N, Aktepe F, Kaya H, et al. Immunohistochemical expression of PTEN in normal, hyperplastic and malignant endometrium and its correlation with hormone receptors, bcl-2, bax, and apoptotic index. Pathol Res Pract 2007;203(3):153–162. DOI: 10.1016/j.prp.2007.01.003.
An HJ, Lee YH, Cho NH, et al. Alteration of PTEN expression in endometrial carcinoma is associated with the down-regulation of cyclin-dependent kinase inhibitor, p27. Histopathology 2002; 41(5):437–445. DOI: 10.1046/j.1365-2559.2002.01455.x.
Sandeepa S, Jayaprakash HT, Ashwini MC. Age-specific prevalence of endometrial hyperplasia in a tertiary care centre from south India. Indian J Pathol Oncol 2017;4(1):108–110. DOI: 10.18231/2394-6792.2017.0021.
Reed SD, Newton KM, Clinton WL, et al. Incidence of endometrial hyperplasia. Am J Obstet Gynecol 2009;200(6):678.e1–678.e6. DOI: 10.1016/j.ajog.2009.02.032.
El Sheikh SA, Elyasergy DF. Immunoreactivity of PTEN in cyclic endometrium and endometrial hyperplasia. World J Med Sci 2016;13(2):126–132. DOI: 10.5829/idosi.wjms.2016.13.2.1159.
Feng ZZ, Chen JW, Yang ZR, et al. Expression of PTTG1 and PTEN in endometrial carcinoma: Correlation with tumorigenesis and progression. Med Oncol 2012;29(1):304–310. DOI: 10.1007/s12032-010-9775-x.
Raffone A, Travaglino A, Saccone G, et al. Loss of PTEN expression as diagnostic marker of endometrial precancer: A systematic review and meta-analysis. Acta Obstet Gynecol Scand 2019;98(3):275–286. DOI: 10.1111/aogs.13513.