The Value of Immunoexpression of Phosphate and Tensin Homolog, Glucose Transporter-1 and b-Catenin in Endometrioid Carcinoma and its Precursor Lesions, MARIEM EL-FIKY, NAGLAA RAMADAN, YOSRYA EL-GOHARY and OSAMA HELMY
Abstract
Background: Endometrial carcinoma is the most common malignancy in the female genital tract and associated with considerable degree of morbidity. Endometrial carcinoma has traditionally been divided into type I and type II cancers. Type I tumors are low grade endometrioid carcinoma that frequently arise in a setting of excess estrogen and associated with good clinical outcome while type II are high grade which have aggressive clinical course and hormone-independent patho-genesis.
Aim of Work: To study the value of expression of phosphate and tensin homolog (PTEN), glucose transporter-1 (GLUT-1) and (3-catenin in endometrioid carcinoma and its precan-cerous lesions as predictive markers for endometrioid carci-noma.
Methods: PTEN, Glut-1 and (3-catenin expressions were evaluated using Immunohistochemical staining in 25 cases of endometrial hyperplasia and 25 cases of endometrioid carcinoma.
Results: Positive PTEN immunoexpression was found in all cases of normal proliferative endometrium, 21 cases (84%) of endometrial hyperplasia, and 13 cases (52%) of endometrioid carcinoma with a highly statistically significant correlation between PTEN immunoexpression in endometrial hyperplasia and endometrioid carcinoma (p.value=0.013). All cases of normal proliferative endometrium, 19 cases (76%) of endome-trial hyperplasia were negative Glut-1 immunoexpression while positive Glut-1 immunoexpression was found in 22 cases (88%) of endometrioid carcinoma with a highly statis-tically significant correlation between Glut-1 immunoexpres-sion in endometrial hyperplasia and endometrioid carcinoma (p.value <0.001). Positive membranous (3-catenin immunoex-pression was found in all cases of normal proliferative en-dometrium and 23 cases (92%) of endometrial hyperplasia while no immunoexpression was found in endometrioid car-cinoma. Positive cytoplasmic (3-catenin immunoexpression was found in 13 cases (52%) of endometrioid carcinoma which was higher than found in endometrial hyperplasia and these findings were statistically significant (Mean: 41 vs 0; p<0.001). Positive nuclear (3-catenin immunoexpression was found in 12 cases (48%) of endometrioid carcinoma which was higher than endometrial hyperplasia and these findings were statistically significant (Mean: 3 vs 0; p<0.001).
Conclusions: Loss of PTEN expression as detected by immunohistochemistry is an informative biomarker for en-dometrial neoplasia. Lack of PTEN expression and GLUT1 overexpression are early events in tumorgensis of endometrioid carcinoma and the different patterns of expression of PTEN and GLUT1 were helped in distinguishing endometrial hyper-plasia from endometrioid carcinoma. Cytoplasmic and nuclear (3-catenin immunoexpression may be useful for a correct early diagnosis of of endometrioid carcinoma.