Abstract

Context: A comparison of PTEN and p53 expression in endometrial hyperplasia and carcinoma.

Aims: To study the histomorphology and expression of PTEN and p53 markers in endometrial hyperplasia and carcinoma in histopathology samples. Settings and Design: This is a comparative study done on 40 cases of endometrial hyperplasia and 20 cases of endometrial carcinoma.

Methods and Material: This is a 2 year study done on 40 cases of endometrial hyperplasia and 20 cases of endometrial carcinoma in a tertiary care hospital. Endometrial biopsies and resected specimens of uterus received at pathology department were grossed, processed and were stained by hematoxylin and eosin and examined by the pathologist. The expression of PTEN and p53 markers was evaluated on the diagnosed samples.

Results: Out of 36 cases of endometrial hyperplasia without atypia, 4 atypical hyperplasias and 20 endometrioid carcinomas, loss of PTEN expression was found to be 16.7%, 25% and 80% respectively, whereas expression of p53 was found to be 5.6%, 75% and 90% respectively in the same cases.

Conclusions: The loss of PTEN expression or positive expression of p53 in hyperplasias may be used as an early indicator of progression to carcinoma. The altered expressions of these markers are initiated in few cases of hyperplasia, which may progress to atypical hyperplasia, a premalignant lesion and ultimately develop into carcinoma.

• 1.   Dar M, Sharma K. Burden of cancer in India: GLOBOCON 2018 estimates incidence, mortality, prevalence and future projections of cancer in India. J Emerg Technol Innovat Res. 2018;6(6):e505.
• 2.   Kurman RJ. Diagnosis of Endometrial Biopsies and Curettings: A Practical Approach. 2nd ed. New York: Springer; 2005. p. 208–50.
• 3.   Daniilidou K, Frangou-Plemenou M, Grammatikakis J, et al. Prognostic significance and diagnostic value of PTEN and p53 expression in endometrial carcinoma: a retrospective clinicopathological and immunohistochemical study. J BUON. 2013;18(1):195–201.
• 4.   Garg K, Broaddus RR, Soslow RA, et al. Pathologic scoring of PTEN immunohistochemistry in endometrial carcinoma is highly reproducible. Int J Gynecol Pathol. 2012;31(1):48–56.
• 5.   Alkushi A, Lim P, Coldman A, et al. Interpretation of p53 immunoreactivity in endometrial carcinoma: establishing a clinically relevant cut-off level. Int J Gynecol Pathol. 2004 Apr;23(2):129–37.
• 6.   Emons G, Beckmann MW, Schmidt D, et al. New WHO classification of endometrial hyperplasias. Geburtshilfe Frauenheilkd. 2015;75(2):135–6.
• 7.   Tantbirojn P, Triratanachat S, Trivijitsilp P, et al. Detection of PTEN immunoreactivity in endometrial hyperplasia and adenocarcinoma. J Med Assoc Thai. 2008;91(8):1161–5.
• 8.   Sarmadi S, Izadi-Mood N, Sotoudeh K, et al. Altered PTEN expression: a diagnostic marker for differentiating normal, hyperplastic and neoplastic endometrium. Diagn Pathol. 2009;4:41.
• 9.   Shanmugapriya M, Sudha M, Geetha P. A study of PTEN expression in endometrial hyperplasia and endometrioid type of endometrial carcinoma. Trop J Path Micro. 2017;3(1):39–45.
• 10.   Risinger JI, Hayes K, Maxwell GL, et al. PTEN mutation in endometrial cancers is associated with favorable clinical and pathologic characteristics. Clin Cancer Res. 1998;4(12):3005–10.
• 11.   Boruban MC, Altundag K, Kilic GS, Blankstein J. From endometrial hyperplasia to endometrial cancer: insight into the biology and possible medical preventive measures. Eur J Cancer Prev. 2008;17(2):133–8.
• 12.   Masjeed NMA, Khandeparkar SGS, Joshi AR, et al. Immunohistochemical study of ER, PR, Ki67 and p53 in endometrial hyperplasias and endometrial carcinomas. J Clin Diagn Res. 2017;11(8):EC31–EC34.