Can malignant potential of endometrial polyps be determined by incorporating the endometrial intraepithelial neoplasia (EIN) classification?

AbstractEndometrial intraepithelial neoplasia (EIN) is a monoclonal neoplastic cell proliferation of the endometrium associated with a significantly increased risk of endometrioid endometrial adenocarcinoma. We herein present the case of a 58-year-old female patient who underwent a hysterectomy with bilateral salpingo-oophorectomy because of the existence of endometrial intraepithelial neoplasia in an endometrial polyp. The patient had irregular uterine bleeding, which lasted 10 days. An endometrial polyp was diagnosed by ultrasound examination. The polyp was located in the isthmus of the uterus, on the back wall, and measured 32 mm × 25 mm. The patient underwent fractional dilation and curettage, and the specimens were subjected to a histopathological examination. The histopathological findings were EIN, endometrioid type, a focus of which was found within the endometrial polyps, as well as the endometrial polyp and proliferative endometrium. The endocervical tissue was normal. Given the age of the patient and the histopathological findings, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The final histopathological findings were EIN, endometrioid type with a focus found within the endometrial polyp; endometrial polyp; simple hyperplasia; chronic inflammation of the uterine cervix; hyperkeratosis of the cervical squamous epithelium; and cervicitis chronica. There was also hydrosalpinx of the left fallopian tube, and cystic follicles in the left ovary. There was no significant morphological change in the right ovary or fallopian tube. The surgical and postoperative course were normal. The patient was sent home on the fifth postoperative day in good general condition. A check-up performed one month after surgery showed normal findings.

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KISS1, P53, and PTEN immunoexpressions and prediction of malignancy in endometrial intraepithelial neoplasia lesion within endometrial polyp

Medical Science and Discovery ◽

10.36472/msd.v7i10.425 ◽

2020 ◽

Vol 7 (10) ◽

pp. 663-669

Author(s):

Eser Çolak ◽

Hilal Özgür Erinanç ◽

Semra Eroglu ◽

Tahir Eryılmaz ◽

Emel Ebru Özçimen ◽

...

Keyword(s):

Intraepithelial Neoplasia ◽

Endometrial Polyp ◽

Cross Sectional ◽

Endometrial Polyps ◽

Convenience Sample ◽

P53 Expression ◽

Gynecology And Obstetrics ◽

Number Of Patients ◽

Endometrial Intraepithelial Neoplasia ◽

Strong Staining

Objective: Aim of this study to evaluate the usefulness of phosphase and tensin homologous deleted on chromosome 10 (PTEN), p53, and kisspeptin (KISS1) immunoexpressions in predicting malignancy in endometrial intraepithelial neoplasia within the endometrial polyps. Material and method: This cross-sectional study was based on chart data from a convenience sample of patients who underwent probe curetage at the Gynecology and Obstetrics Clinic of Başkent University Ankara and Konya Practice and Research Hospitals, Turkey. A total of 169 patients were allocated into 5 groups, comprising the EIN-p group: 62 patients with an endometrial intraepithelial neoplasia lesion within an endometrial polyp, EC group: 17 patients with an endometrial carcinoma, EP-h group: 30 patients with hyperplasia on the background of the polyp but no atypia, EP group: 30 patients with endometrial polyps, and NE group: 30 patients with a normal (proliferative) endometrium. P53, PTEN, and KISS1 expressions between the groups were evaluated. Results: In the EIN-p and EC groups, P53 and KISS1 expressions were moderate or strong. In the NE, EP and EP-h groups, KISS1 was weakly stained and P53 expression was negative. The number of patients with strong p53 and KISS1 expressions in the EC group was higher and this difference was statistically significant (P < 0.001). With PTEN immunostaining, the EC and EIN-P groups were weakly stained, whereas the NE, EP, and EP-h groups had moderate or strong staining. Strong staining rates were higher in patients in the NE and EP groups than in the EP-h group (P < 0.001). Conclusion: In addition to the literature about P53 and PTEN, according to the data obtained herein, it was speculated that KISS1 may play an important role in the malignant transformation of endometrial polyps and it might be used as a predicting marker in this patient group.

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Endometrial hyperplasia (Clinical lecture)

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.10 ◽

2016 ◽

pp. 10-18 ◽

Cited By ~ 2

Author(s):

I.B. Vovk ◽

◽

N.Е. Gorban ◽

O.Ju. Borysiuk ◽

◽

...

Keyword(s):

Key Words ◽

Hormonal Therapy ◽

Endometrial Hyperplasia ◽

Intraepithelial Neoplasia ◽

Diagnosis And Treatment ◽

Pathogenetic Mechanisms ◽

Endometrial Intraepithelial Neoplasia ◽

Mechanisms Of Development ◽

Clinical Lecture

In clinical lecture presents modern views of endometrial hyperplasia in terms of practitioner gynecologist. The problems of classification, pathogenetic mechanisms of development of endometrial hyperplasia. Particular attention is paid to modern approaches to diagnosis and treatment of endometrial hyperplasia. Key words: hyperplasia, endometrium, classification, endometrial hyperplasia, endometrial intraepithelial neoplasia, hormonal therapy.

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Molecular Classification to Prognosticate Response in Medically Managed Endometrial Cancers and Endometrial Intraepithelial Neoplasia

Cancers ◽

10.3390/cancers13112847 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2847

Author(s):

Allison M. Puechl ◽

Daniel Spinosa ◽

Andrew Berchuck ◽

Angeles Alvarez Secord ◽

Kerry E. Drury ◽

...

Keyword(s):

Endometrial Cancer ◽

Single Gene ◽

Intraepithelial Neoplasia ◽

Molecular Classification ◽

Definitive Treatment ◽

Time To Progression ◽

Endometrial Intraepithelial Neoplasia ◽

Definitive Therapy ◽

Patients At Risk ◽

Endometrial Cancers

Background: The aim of this study was to evaluate whether molecular classification prognosticates treatment response in women with endometrial cancers and endometrial intraepithelial neoplasia (EIN) treated with levonorgestrel intrauterine system (LNG-IUS). Methods: Patients treated with LNG-IUS for endometrial cancer or EIN from 2013 to 2018 were evaluated. Using immunohistochemistry and single gene sequencing of POLE, patients were classified into four groups as per the Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE): POLE-mutated, mismatch repair-deficient (MMRd), p53 wild type (p53wt), and p53-abnormal (p53abn). Groups were assessed relative to the primary outcome of progression or receipt of definitive treatment. Results: Fifty-eight subjects with endometrioid endometrial cancer or EIN treated with LNG-IUS were included. Of these, 22 subjects (37.9%) had endometrial cancer and 36 subjects (62.1%) had EIN. Per the ProMisE algorithm, 44 patients (75.9%) were classified as p53wt, 6 (10.3%) as MMRd, 4 (6.9%) as p53abn, and 4 (6.9%) as POLE-mutated. Of the 58 patients, 11 (19.0%) progressed or opted for definitive therapy. Median time to progression or definitive therapy was 7.5 months, with p53abn tumors having the shortest time to progression or definitive therapy. Conclusions: Molecular classification of endometrial cancer and EIN prior to management with LNG-IUS is feasible and may predict patients at risk of progression.

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