Mutational profile of endometrial hyperplasia and risk of progression to endometrioid adenocarcinoma

Cancer ◽  
2020 ◽  
Vol 126 (12) ◽  
pp. 2775-2783 ◽  
Author(s):  
Mariano Russo ◽  
Jordan M. Newell ◽  
Laura Budurlean ◽  
Kenneth R. Houser ◽  
Kathryn Sheldon ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrioid Adenocarcinoma ◽  
Risk Of Progression

Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatment

2004 ◽  
Vol 14 (2) ◽  
pp. 348-353 ◽  
Author(s):  
L.-C. Horn ◽  
U. Schnurrbusch ◽  
K. Bilek ◽  
B. Hentschel ◽  
J. Einenkel
Keyword(s):  
Vaginal Bleeding ◽  
Endometrial Hyperplasia ◽  
Hormonal Treatment ◽  
Atypical Hyperplasia ◽  
Endometrioid Adenocarcinoma ◽  
Endometrioid Carcinoma ◽  
Total Hysterectomy ◽  
Atypical Endometrial Hyperplasia ◽  
Risk Of Progression ◽  
Leading Symptom

In most cases, the endometrioid adenocarcinoma of the endometrium is preceded by hyperplasia with different risk of progression into carcinoma. The original histologic slides from 560 consecutive cases with complex and atypical hyperplasia were re-examined to assess the interobserver-correlation. The hyperplasias were analyzed separately for their likelihood of progression to carcinoma in patients with and without progestogen hormonal therapy. In all cases, a fractional re-curreting was performed to establish the state of the disease.The leading symptom was vaginal bleeding in 65.5% of the cases in the postmenopausal period. Eighty-six percent of the patients presented with obesity (BMI > 30 kg/m2), 23% had had an exogeneous use of estrogens. Twenty-two cases were reclassified as simple hyperplasia and excluded from further analysis. The interobserver-correlation was 91% for complex, 92% for atypical hyperplasia, and 89% for endometrioid carcinoma, representing an overall correlation of 90%. Two percent of the cases with complex hyperplasia (8/390) progressed into carcinoma and 10.5% into atypical hyperplasia. Fifty-two percent of the atypical hyperplasias (58/112) progressed into carcinomas. In the case of progestogen treatment (n = 208; P < 0.0001) 61.5% showed remission confirmed by re-curetting, compared with 20.3% of the cases without hormonal treatment (n = 182; P < 0.0001).Endometrial hyperplasia without atypia is likely to respond to hormonal treatment. Especially in postmenopausal situation, atypical hyperplasia should be treated with total hysterectomy.

Expression of survivin, PTEN and p27 in normal, hyperplastic, and carcinomatous endometrium

2006 ◽  
Vol 16 (3) ◽  
pp. 1412-1418 ◽  
Author(s):  
S. Erkanli ◽  
F. Kayaselcuk ◽  
E. Kuscu ◽  
T. Bagis ◽  
F. Bolat ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Endometrial Hyperplasia ◽  
Survivin Expression ◽  
Myometrial Invasion ◽  
Immunohistochemical Analysis ◽  
Endometrioid Adenocarcinoma ◽  
Tissue Samples ◽  
Proliferative Endometrium ◽  
Endometrial Carcinomas ◽  
First Time

We aimed to investigate if expressions of survivin and p27 proteins are involved in the development of endometrioid carcinoma, along with whether there are any correlations between these proteins and loss of wild-type PTEN that is found in up to 80% of endometrial carcinomas. We also studied their correlations with classical prognostic factors and survival in endometrial carcinoma. To our knowledge, this is the first time survivin expression is investigated in endometrial hyperplasia along with endometrioid adenocarcinoma. For immunohistochemical analysis, 29 endometrioid adenocarcinoma, 38 endometrial hyperplasia, and 10 proliferative endometrium tissue samples were selected in the pathology archives. Staining of cells was scored as +2 if >50%, +1 if <50%, and negative if none were stained positive. Survivin expression increased from proliferative to hyperplasia to carcinoma cases. PTEN and p27 expressions decreased in hyperplasia and carcinoma cases with respect to proliferative endometrium. All these differences were statistically significant (P < 0.05). PTEN positively correlated to p27 (P < 0.05); however, neither was correlated with survivin. None of these genes were correlated with classical prognostic factors such as grade and myometrial invasion in endometrioid adenocarcinoma. However, mean survival was statistically significantly higher in PTEN-positive cases (46.6 vs 16.4 months) (P < 0.05). Survivin overexpression might be one of the important mechanisms in the development of endometrioid adenocarcinoma along with lost or decreased activity of PTEN and p27. However, survivin seems to exert its role in ways different from those of PTEN or p27 in the development of endometrioid adenocarcinoma. These findings on the role of survivin in endometrioid adenocarcinoma should be confirmed and the pathways through which survivin acts in endometrioid adenocarcinoma studied further with a larger sample size.

The additional prognostic value of morphometric nuclear arrangement and DNA-ploidy to other morphometric and stereologic features in endometrial hyperplasias

1994 ◽  
Vol 4 (5) ◽  
pp. 289-297 ◽  
Author(s):  
J. P.A. Baak ◽  
D. J. Kuik ◽  
P. D. Bezemer
Keyword(s):  
Sensitivity And Specificity ◽  
Prognostic Value ◽  
Endometrial Hyperplasia ◽  
Dna Ploidy ◽  
High Sensitivity ◽  
Basal Membrane ◽  
Volume Percentage ◽  
Group Score ◽  
Risk Of Progression ◽  
Additional Value

Earlier studies have shown that morphometric analysis of nuclear size and shape features and stereologic analysis of gland architecture in endometrial hyperplasia are useful to predict the risk of progression to cancer. A multivariate discriminatory D-score using these features has a higher sensitivity than qualitative microscopic characteristics (nuclear atypicality and glandular complexity) when an appropriate threshold is chosen. In the present study, the (additional) prognostic value of morphometric features related to the arrangement of nuclei in glands (distance of nuclear centroids to basal membrane, angle of longest nuclear axis with basal membrane) and DNA-ploidy (determined by flow cytometry) has been analyzed in 39 cases of endometrial hyperplasia, seven (18%) of which have progressed to cancer. Variation in stratification of nuclei has prognostic value, in contrast to DNA-ploidy. Multivariate analysis selects the outer surface density of the glands, mean distance, volume percentage of lumen and the coefficient of variation of nuclear axes as having separate and additional value. A multivariate rule called HYPER-score results from these features. With this score a high-risk (score value ≥0.20, nine cases, 78% progressed) and a low-risk group (score value <0.20, 30 cases, none progressed) can be discerned. The prognostic value, sensitivity and specificity of the hyper-score greatly exceeds that of any of the previously described prognostic factors in endometrial hyperplasias. An additional clinical advantage is that with the HYPER-score two groups (instead of four groups as with Kurman's method(1)) with a high sensitivity and specificity can be discerned. The morphometric and stereologic features agree well with the usual qualitative predictors but have much stronger prognostic value.

Endometrial hyperplasia and the risk of progression to carcinoma

Maturitas ◽  
2009 ◽  
Vol 63 (1) ◽  
pp. 39-44 ◽  
Author(s):  
James V. Lacey ◽  
Victoria M. Chia
Keyword(s):  
Endometrial Hyperplasia ◽  
Risk Of Progression

Ezrin, a membrane-cytoskeletal linking protein, is highly expressed in atypical endometrial hyperplasia and uterine endometrioid adenocarcinoma

2002 ◽  
Vol 179 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Kaori Ohtani ◽  
Hideki Sakamoto ◽  
Thomas Rutherford ◽  
Zhaocong Chen ◽  
Atushi Kikuchi ◽  
...  
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrioid Adenocarcinoma ◽  
Atypical Endometrial Hyperplasia

COMPARISON OF ENDOMETRIAL INTRAEPITHELIAL NEOPLASIA & WHO CLASSIFIED ENDOMETRIAL HYPERPLASIA IN PREDICTING THE RISK OF PROGRESSION TO ENDOMETRIAL CARCINOMA

2021 ◽  
pp. 59-61
Author(s):  
Bansi Kavar ◽  
Neeru Dave
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Hyperplasia ◽  
Intraepithelial Neoplasia ◽  
Atypical Hyperplasia ◽  
Cytological Atypia ◽  
Endometrial Intraepithelial Neoplasia ◽  
Risk Of Progression ◽  
Classi Cation ◽  
Cation System ◽  
Sampling Procedures

Background: Endometrial hyperplasia is the precursor lesion of most endometrial cancers of endometrioid type. The most commonly used classication system for endometrial hyperplasia is WHO 1994 classication system in which architecture disruption and cytological atypia are used to identify four types of endometrial hyperplasia including simple or complex hyperplasia with or without atypia. Newer EIN diagnosis by cytological atypia is of great consideration for the progression to endometrial cancer. Material And Methods: The study consists of 100 cases of WHO classied endometrial hyperplasia for period of 4 yrs from 2015 to 2019. Type of sampling procedures- dilation & curettage, endometrial biopsy and fractional curettage. Objective: 1. To discuss revised criteria for recognition of endometrial intraepithelial neoplasia (EIN). 2. To nd out the sensitivity of endometrial intraepithelial neoplasia (EIN) classication in predicting the risk of malignancy. Results: This study consists of 100 cases of endometrial hyperplasia. Patients were mostly postmenopausal & presented with abnormal vaginal bleeding. From WHO classied endometrial lesions, 2 out of 35 cases of simple typical hyperplasia, 10 out of 14 cases of complex typical hyperplasia,12 out of 20 cases of simple atypical hyperplasia and 20 out of 21 cases of complex atypical hyperplasia were reclassied as EI N. Conclusion: To estimate the risk of progression to carcinoma and guide clinical management, the histo-pathologic diagnosis of endometrial hyperplastic lesion is very important, specially the diagnosis of EIN lesions. EIN carries a much greater risk of progression to endometrial cancer than other WHO classied endometrial hyperplasia.

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