Emerging relationships between papillary proliferation of the endometrium and endometrial carcinoma: evidence from an immunohistochemical and molecular analysis

Papillary proliferation of the endometrium (PPE) is an uncommon lesion that frequently shows mucinous metaplasia. PPE occasionally has concurrent or preceding endometrial hyperplasia and carcinomas, but there is little molecular evidence to support the relationships between PPEs and endometrial neop...

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Bibliographic Details
Published in:Virchows Archiv : an international journal of pathology 2019-08, Vol.475 (2), p.201-209
Main Authors: Liu, Qin, Wu, Qiongyan, Yu, Minghua, Shi, Haiyan, Lu, Bingjian
Format: Article
Language:English
Subjects:
AKT1 protein
Carcinoma
Endometrial cancer
Endometrium
Exons
Hyperplasia
Immunohistochemistry
Medicine
Medicine & Public Health
Metaplasia
Mutation
Mutation hot spots
Original Article
Pathology
Pax2 protein
PTEN protein
Uterine cancer
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Summary:Papillary proliferation of the endometrium (PPE) is an uncommon lesion that frequently shows mucinous metaplasia. PPE occasionally has concurrent or preceding endometrial hyperplasia and carcinomas, but there is little molecular evidence to support the relationships between PPEs and endometrial neoplasia. In this study, we analyzed the clinicopathological and immunohistochemical features in 30 PPEs (22 simple PPEs and 8 complex papillary hyperplasia (CPH)). Hotspot mutations of KRAS , PI3KCA , AKT1 , PTEN (exons 3, 5, and 7), and ARID1A (exons 1 and 14) were detected by pyrosequencing or bidirectional Sanger sequencing. We found that endometrial hyperplasia and carcinoma were more common in CPHs (4/6, 66.7%) than in simple PPEs (4/21, 19.0%) ( p   0.05). KRAS mutations were identified in 14 PPEs and 1 concurrent endometrial carcinoma. The prevalence of KRAS mutations was not statistically different between simple PPEs (10/21, 45.5%) and CPHs (4/8, 50%) ( p  > 0.05), but was higher in PPEs displaying mucinous metaplasia (12/24, 50%) than in those without (2/6, 33.3%) ( p  
ISSN:0945-6317
1432-2307
DOI:10.1007/s00428-019-02589-7