PAX2 Expression in Endometrial Intraepithelial Neoplasia

In order to avoid the consequences of over- and under-treatment of endometrial hyperplasia, diagnostic accuracy and progression risk assessment must be improved. The aim of this study was to assess whether PAX2 or PTEN expression could predict progression-free survival in endometrial intraepithelial neoplasia (EIN) and endometrial endometrioid carcinoma (EEC). Immunohistochemistry for detection of PAX2 and PTEN was performed on 348 endometrial samples; 75 proliferative endometrium (PE), 36 EIN and 237 EEC. Cases classified as PTEN null (1 or more glands negatively stained) were more prevalent in EEC than in PE and EIN (64% EEC vs 11% PE/EIN). A progressive decrease in PAX2 expression was observed from PE to EIN to EEC. Long-term clinical follow-up (6–310 months, median: 126) was available for 62 PE cases, all 36 EIN cases and 178 EEC cases. No patients with PE demonstrated progression to EIN or EEC. Progression of disease was observed in 10 (28%) EIN patients. These patients had significantly lower PAX2 expression than those that regressed (P = 0.005). Progression-free survival analysis revealed that EIN patients with a high-risk PAX2 expression score (H-score ≤75) had a higher probability of progression of disease in comparison to those with a low-risk score (H-score >75). PAX2 expression was not prognostic in EEC nor was PTEN status of prognostic value in either EIN or EEC. PAX2 expression analysis by means of H-score has prognostic potential for the identification of high-risk progression cases in EIN but needs to be validated in a larger cohort.

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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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