Objective Biomarkers in Endometrioid-Type Endometrial Carcinogenesis

摘要: Endometrial hyperplasia (EH) is a common disease. An estimated 180,000–200,000 new cases occur annually in the Western world; approx 39,200 and 6600 deaths were expected United States 2002 (1). About 8–20% of all EH associated with subsequent endometrial cancer endometrioid type. Major problems treating include poor diagnostic reproducibility inaccurate prediction progression. This has resulted enormous overtreatment. The World Health Organization (WHO)’s 1994 histologic classification widely used but not reproducible, does adequately predict risk progression, lacks molecular cell biology basis. Computerized morphometric analysis identified multivariate combination architectural nuclear features, called DS, which fits therapeutic options, accurately predicts outcome. Cases DS ≥1 have negligible progression (0.3%), contrasting 37% for those < 1 found large multicenter study more than 18 yr follow-up. Moreover, molecular-genetic studies {tly|464-1} strong correlation between clonality DS; monoclonal nearly always 0; ≥ are mostly polyclonal. classification, intraepithelial neoplasia (EIN), mimic subjective WHO diagnoses rather uses criteria prognostic endpoints. high-risk EIN-DS lesions often show clonal inactivation phosphatase tensin homologue (PTEN) tumor-supressor gene by immunohistochemistry. Based on EIN-DS, patients can now be reproducibly assigned high accuracy to high- low-risk categories, permitting appropriate management. application easy, done standard sections, reasonable cost. thus assessed any pathology laboratory, sections also sent reference laboratories measurement if necessary.