Utility of a PAX2, PTEN, and β-catenin Panel in the Diagnosis of Atypical Hyperplasia/Endometrioid Intraepithelial Neoplasia in Endometrial Polyps.

Autor:	Lucas E; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Niu S; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Aguilar M; Department of Pathology., Molberg K; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Carrick K; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Rivera-Colon G; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Gwin K; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX., Wang Y; Department of Pathology., Zheng W; Department of Pathology.; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center.; Department of Pathology, Parkland Hospital, Dallas, TX., Castrillon DH; Department of Pathology.; Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center.; Department of Pathology, Parkland Hospital, Dallas, TX., Chen H; Department of Pathology.; Department of Pathology, Parkland Hospital, Dallas, TX.
Jazyk:	angličtina
Zdroj:	The American journal of surgical pathology [Am J Surg Pathol] 2023 Sep 01; Vol. 47 (9), pp. 1019-1026. Date of Electronic Publication: 2023 Jun 14.
DOI:	10.1097/PAS.0000000000002076
Abstrakt:	The diagnosis of atypical hyperplasia/endometrioid intraepithelial neoplasm (AH/EIN) within endometrial polyps (EMPs) often poses a diagnostic conundrum. Our previous studies demonstrated that a panel of immunohistochemical (IHC) markers consisting of PAX2, PTEN, and β-catenin can be effectively utilized for the identification of AH/EIN. A total of 105 AH/EIN within EMP were analyzed using the 3-marker panel. We also evaluated these cases for the presence of morules. Benign EMP (n=90) and AH/EIN unassociated with polyp (n=111) served as controls. Aberrant expression of PAX2, PTEN, or β-catenin was observed in AH/EIN in EMP in 64.8%, 39.0%, and 61.9% of cases, respectively. At least 1 IHC marker was abnormal in 92.4% of cases. Overall, 60% of AH/EIN in EMP demonstrated abnormal results for≥2 IHC markers. The prevalence of PAX2 aberrancy was significantly lower in AH/EIN in EMP than in nonpolyp AH/EIN (64.8% vs. 81.1%, P =0.007), but higher than in benign EMP (64.8% vs. 14.4%, P <0.00001). The prevalence of β-catenin aberrancy was significantly higher in AH/EIN in EMP than in nonpolyp AH/EIN (61.9% vs. 47.7%, P =0.037). All control benign EMP demonstrated normal expression of PTEN and β-catenin. Morules were present in 38.1% of AH/EIN in EMP versus 24.3% in nonpolyp AH/EIN, and absent in benign EMP. A strong positive association was found between β-catenin and morules (Φ=0.64). Overall, 90% cases of atypical polypoid adenomyoma (n=6) and mucinous papillary proliferation (n=4) showed IHC marker aberrancy. In conclusion, the 3-marker IHC panel (PAX2, PTEN, and β-catenin) is (1) a useful tool in the diagnosis of AH/EIN in EMP; (2) PAX2 loss should be interpreted with caution and in combination with morphology and other markers. Competing Interests: Conflicts of Interest and Source of Funding: Supported by the Philip O’Bryan Montgomery endowment fund, UTSW to K.M., Mark and Jane Gibson Distinguished Professorship endowment fund to W.Z., and start-up fund and intramural research fund of the Department of Pathology, UTSW to H.C. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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