Altered PTEN expression; A diagnostic marker for differentiating normal, hyperplastic and neoplastic endometrium
Different molecular alterations have been described in endometrioid endometrial carcinoma (EECA). Among them the most frequently altered is loss of the PTEN protein, a tumor suppressor gene. The purpose of this study was to evaluate the expression pattern of PTEN gene in normal, hyperplastic and neoplastic endometrium. In a study in a referral gynecologic hospital in Tehran, Iran, immunohistochemical (IHC) evaluation of PTEN was performed on 87 consecutive specimens to the following three groups; group A- normal proliferative endometrium(n = 29); group B- hyperplastic endometrium [including simple hyperplasia without atypia(n = 21) and complex hyperplasia with atypia (n = 8)] and group C- EECA(n = 29). Immunostaining of cells was analyzed by arbitrary quantitative methods according to both slide's area staining and intensity of color reaction. PTEN immunoreactivity was present in all normal proliferative endometrium, all simple hyperplasia, 75% of atypical complex hyperplasia and in 48% of EECA (P < 0.001). The intensity of PTEN reaction was significantly higher in group with proliferative endometrium than hyperplastic endometrium and EECA (P < 0.001). PTEN expression was significantly higher in cyclical endometrium than in atypical hyperplasia and endometrioid carcinoma.
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Expression of matrix-metalloproteinases (MMP-2, -7 and -9), tissue inhibitors of matrix-metalloproteinases (TIMP-1 and -2), apoptotic factors (P53 and Bcl-2) and steroid receptors (estrogen and progesterone receptors) in normal, hyperplastic and neoplastic endometrium : a clinical-pathological correlation study : fluorescence in situ hybridization and immunohistochemical analysis of P53 expression in endometrial cancer : prognostic value and relation to ploidy