PTEN expression in endometrial biopsies as a marker of progression to endometrial carcinoma

Inactivation of PTEN tumor suppressor gene is common in endometrial carcinoma and its precursor, atypical endometrial hyperplasia (EH). We compared PTEN expression via immunohistochemistry in endometrial biopsies diagnosed as EH in 138 cases, who were diagnosed with EH and then endometrial carcinoma...

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Published in:Cancer research (Chicago, Ill.) Ill.), 2008-07, Vol.68 (14), p.6014-6020
Main Authors: Lacey, Jr, James V, Mutter, George L, Ronnett, Brigitte M, Ioffe, Olga B, Duggan, Máire A, Rush, Brenda B, Glass, Andrew G, Richesson, Douglas A, Chatterjee, Nilanjan, Langholz, Bryan, Sherman, Mark E
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy
Carcinoma - metabolism
Case-Control Studies
Disease Progression
Endometrial Neoplasms - metabolism
Endometrium - metabolism
Female
Gene Expression Profiling
Gene Expression Regulation, Neoplastic
Humans
Middle Aged
PTEN Phosphohydrolase - biosynthesis
PTEN Phosphohydrolase - genetics
Sensitivity and Specificity
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Summary:Inactivation of PTEN tumor suppressor gene is common in endometrial carcinoma and its precursor, atypical endometrial hyperplasia (EH). We compared PTEN expression via immunohistochemistry in endometrial biopsies diagnosed as EH in 138 cases, who were diagnosed with EH and then endometrial carcinoma at least 1 year later (median, 6 years), and 241 individually matched controls, who were diagnosed with EH but did not progress to carcinoma during equivalent follow-up. We assessed PTEN status (normal versus null) in index biopsies containing EH to estimate the relative risk (RR) of developing endometrial carcinoma up to 25 years later. Analysis of 115 cases and 193 controls with satisfactory assays revealed PTEN-null glands in index biopsies of 44% of cases and 49% of controls [P = 0.85; RR, 1.51; 95% confidence interval (CI), 0.73-3.13]. For predicting progression to carcinoma, PTEN-null status had low sensitivity (44%; 95% CI, 45-54%) and specificity (51%; 95% CI, 44-58%). Among 105 cases with PTEN results for both index biopsy and carcinoma, 16% had a PTEN-null index biopsy, 23% had PTEN-null carcinoma, and 26% had both a PTEN-null index biopsy and carcinoma. Loss of PTEN expression in endometrial biopsies was neither associated with nor a sensitive and specific marker of subsequent progression to endometrial carcinoma.
ISSN:0008-5472
1538-7445
DOI:10.1158/0008-5472.CAN-08-1154