Adenomyosis ; metabolism ; pathology ; Adult ; CA-125 Antigen ; metabolism ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrial Neoplasms ; metabolism ; pathology ; Endometriosis ; metabolism ; pathology ; Female ; Humans ; Hyperplasia ; metabolism ; pathology ; Middle Aged

OBJECTIVETo investigate the diagnostic applications of endometrial intraepithelial neoplasia (EIN), and the expression of PTEN in endometrial lesions.

METHODSFifty-one cases of endometrial lesions were enrolled in this study. Using diagnostic criteria of EIN, the diagnosis were made and compared with the original results. Immunohistochemistry for PTEN was performed in all cases.

RESULTSTwo cases of simple hyperplasia originally diagnosed were reclassified as EIN. Three cases with atypia originally diagnosed showed no EIN pattern. PTEN deletion rates were 50.0%, 50.0%, 66.7% and 81.8% in proliferative endometrium, benign hyperplasia, EIN and endometrial carcinoma, respectively.

CONCLUSIONSDiagnosis of EIN is applicable and its morphology and diagnostic criteria are different from the classical one (WHO94) for endometrial hyperplasia. Detection of PTEN deletion by immunohistochemistry is useful in identifying EIN, but cannot be used as an ultimate confirming factor.

Adult ; Aged ; Carcinoma, Endometrioid ; metabolism ; pathology ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrial Neoplasms ; metabolism ; pathology ; Female ; Humans ; Middle Aged ; PTEN Phosphohydrolase ; metabolism ; Precancerous Conditions ; metabolism ; pathology ; Young Adult

The expression patterns of CD44s and CD44v6 were immunohistochemically compared with those of normal, hyperplastic and malignant endometrium. In normal endometria (n=37), endometrioses (n=46) and adenomyoses (n=20), the surface and glandular epithelial cells were negative for CD44s and CD44v6 in a proliferative pattern and positive in a secretory pattern, whereas the stroma was only positive for CD44s in both proliferative and secretory patterns. The endometrial hyperplasia (4 simple and 9 complex) had the identical patterns with normal proliferative phase of endometrium. Only one case showing complex hyperplasia with atypia was focally positive for CD44s and CD44v6 in glandular epithelia. CD44s and CD44v6 were positive in all endometrial adenocarcinomas (13), except one CD44s-negative case. In summary, the expressions of CD44s and CD44v6 in endometriosis and adenomyosis recapitulated those of normal cyclic endometrium. The expression patterns in endometrial hyperplasia were similar to those in normal proliferative endometrium, whereas the endometrial adenocarcinoma showed abnormal expressions for CD44s and CD44v6. Thus it was considered that the ectopic endometrium in endometriosis and adenomyosis was not aberrant as in endometrial carcinoma on the aspects of immunohistochemical expressions of CD44s and CD44v6.
Adenocarcinoma/*metabolism/pathology ; Antigens, CD44/*metabolism ; Comparative Study ; Endometrial Hyperplasia/*metabolism/pathology ; Endometrial Neoplasms/*metabolism/pathology ; Endometriosis/*metabolism/pathology ; Endometrium/metabolism/pathology ; Female ; Glycoproteins/*metabolism ; Human ; Immunoenzyme Techniques ; Immunohistochemistry ; Ovarian Diseases/*metabolism/pathology ; Staining and Labeling/methods

OBJECTIVETo explore the expression of beta-catenin, Glut-1, PTEN in uterine endometrioid adenocarcinoma and their roles in tumorigenesis.

METHODSA total of 83 cases of endometrial hyperplasia were selected and reclassified according to EIN diagnostic criteria. Expressions of beta-catenin, Glut-1 and PTEN proteins were investigated by immunohistochemistry in 10 proliferative endometrium, 83 endometrial hyperplasia and 24 endometrioid adenocarcinoma.

RESULTS(1) 24 EIN (28.9%) lesions were reclassified among 83 previously diagnosed endometrial hyperplasia, of which, 16 of 24 EIN cases (66.7%) had a prior diagnosis of complex atypical hyperplasia. The relation between EIN diagnosis and grade of atypical hyperplasia was not obvious (P > 0.05). (2) Normal (membranous) expression of beta-catenin was present in 10 cases of proliferative endometrium. Abnormal (marked membranous/cytoplasmic, cytoplasmic and/or nuclear or negative) expression rates of beta-catenin in EIN lesions (50%, 12/24) and endometrioid adenocarcinoma (66.7%, 16/24) were significantly higher than that of benign hyperplasia (10.2%, 6/59) respectively (P < 0.01). However, the difference was not significant between EIN lesions and endometrioid adenocarcinomas (P > 0.05). (3) Low level expressions of Glut-1 was present in proliferative endometrium and benign hyperplasia. Overexpression of Glut-1 was present in 58.3% (14/24) of EIN and 70.8% (17/24) of endometrioid adenocarcinoma, respectively, and statistically not significant (P > 0.05). (4) Percentages of loss of PTEN expression showed no difference between EIN lesions (37.5%, 9/24) and proliferative endometrium (2/10), benign hyperplasia (28.8%, 17/59), endometrioid adenocarcinoma (62.5%, 15/24; P > 0.05). However, loss of PTEN expression in endometrioid adenocarcinoma was significantly higher than those in proliferative endometrium and benign hyperplasia (P < 0.05).

CONCLUSIONSAbnormal expression of beta-catenin and overexpression of Glut-1 may be the early events in tumorigenesis of endometrioid adenocarcinoma. The expression of both markers may be useful in distinguishing a benign hyperplasia from EIN and endometrioid adenocarcinoma. Lack of PTEN expression may be the earliest event in endometrial carcinogenesis. However, it can not be used yet as a diagnostic marker for the EIN lesion.

Adult ; Biomarkers, Tumor ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrial Neoplasms ; metabolism ; pathology ; Female ; Glucose Transporter Type 1 ; metabolism ; Humans ; Immunohistochemistry ; Middle Aged ; PTEN Phosphohydrolase ; metabolism ; beta Catenin ; metabolism

OBJECTIVETo investigate the role of the expression of Ezh2, Runx3 and caspase-3 proteins and their correlation in the pathogenesis of endometrial carcinoma.

METHODSExpression of Ezh2, Runx3 and caspase-3 proteins was examined by tissue microarray technique and immunohistochemistry (SP method) in 72 cases of endometrial adenocarcinomas, 60 endometrial hyperplasia and 30 normal endometrial tissues.

RESULTSThe positive expression rates of Ezh2, Runx3 and caspase-3 proteins in endometrial adenocarcinomas were 83.3% (60/72), 26.4% (19/72) and 33.3% (24/72), respectively. The positive rate of Ezh2 protein in endometrial carcinomas was higher than that in normal endometrium and endometrial hyperplasia (16.7%, 33.3%, 63.3%;P < 0.05). However, the positive rate of Runx3 in endometrial carcinomas was lower than that in normal endometrium and endometrial hyperplasia (80.0%, 56.7%; P < 0.01). The positive rate of caspase-3 protein in endometrial carcinomas was lower than that in normal endometrium and endometrial hyperplasia (86.7%, 73.3%, 63.3%; P < 0.01). Positive expression of Ezh2 and Runx3 was related to the histological grade, FIGO stage, and depth of invasion of endometrial adenocarcinomas (P < 0.05), but it was not related to the lymph node metastasis (P > 0.05). Positive expression of caspase-3 protein was related to the histological grade (P < 0.05), but it was not related to the FIGO stage, depth of invasion and the lymph node metastasis of endometrial adenocarcinomas (P > 0.05). The expression of Ezh2 protein was negatively correlated to that of Runx3 (r(s) = -0.262, P < 0.05).

CONCLUSIONSAbnormal expression of Ezh2, Runx3 and caspase-3 proteins is associated with the development and progression of endometrioid adenocarcinoma. Combined analysis of Ezh2, Runx3 and caspase-3 may offer prognostic information for patients with endometrial cancer.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Aged ; Caspase 3 ; metabolism ; Core Binding Factor Alpha 3 Subunit ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrial Neoplasms ; metabolism ; pathology ; Endometrium ; metabolism ; Enhancer of Zeste Homolog 2 Protein ; Female ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Staging ; Polycomb Repressive Complex 2 ; Transcription Factors ; metabolism

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Adult ; Carcinoma, Endometrioid ; metabolism ; pathology ; Cervix Uteri ; metabolism ; pathology ; surgery ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Diagnosis, Differential ; Electrosurgery ; Endometrial Neoplasms ; metabolism ; pathology ; Female ; Humans ; Hyperplasia ; Keratin-7 ; metabolism ; Mesonephros ; metabolism ; pathology ; surgery ; Neprilysin ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology

OBJECTIVETo investigate the changes in local endometrial contents of estrogen receptors (ER) and progesterone receptors (PR) after insertion of levonorgestrel-releasing intrauterine system (LNG-IUS) and evaluate the efficacy of LNG-IUS in treating endometrial hyperplasia.

METHODSThe endometrial histological changes were observed in 25 anovulatory women with dysfunctional uterine bleeding after insertion of LNG-IUS, and the contents of ERs and PRs in the endometrium were measured by immunohistochemistry.

RESULTSThe endometrial proliferation activity was obviously inhibited 6 months after LNG-IUS insertion with decreased endometrial glands, glandular dysplasia and decidualization of interstitial cells. The positive cell rate for ERs and PRs in the glandular epithelial and interstitial cells were significantly reduced after LNG-IUS insertion.

CONCLUSIONSLNG-IUS can reduce ER and PR expressions in the endometrium and inhibit endometrial proliferation, and therefore can be effective in treating simple and complex endometrial hyperplasia.

Adult ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrium ; pathology ; Female ; Gene Expression Regulation ; drug effects ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; administration & dosage ; pharmacology ; Middle Aged ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism