Lack of PTEN expression in endometrial intraepithelial neoplasia is correlated with cancer progression
Lack of PTEN expression in endometrial intraepithelial neoplasia is correlated with cancer progression
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DOI：
10.1016/j.humpath.2005.02.018
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发表时间：
2005-05-01
期刊：
影响因子：
3.3
通讯作者：
Lovslett, K
中科院分区：
文献类型：
--
作者：
Baak, JPA;van Diermen, B;Lovslett, K
我们检验了PTEN失活可能在假定的子宫内膜增生中对癌症进展风险进行分层的假设，通过形态计量学D评分（DS）进行预后分类。DS由常规苏木精-伊红染色子宫内膜活检切片测量的3个形态计量变量计算得出，是目前可用的最敏感、最特异的子宫内膜癌风险预测方法。根据DS对103例子宫内膜增生活检患者的临床结果进行统计。随访期间7例（7/103;7%）癌患者均分布在预后高危组（即DS < 1 =子宫内膜上皮内瘤变[EIN]）（7/21； 33%进展）。82例DS高于I的病例均无进展。所有进展的病例均为PTEN无效，表明该基因型能够进一步分层增生的癌症进展风险，而不考虑组织学分类。然而，只有16%的pten无效病例进展。当PTEN表达模式与EIN联合时，预后能力大大提高（特异性从PTEN的63%和EIN的85%联合到93%；阳性预测值从16%和33%增加到50%）。我们得出结论，PTEN表达缺失是EIN中第一个提高预后DS预测癌症进展风险准确性的生物标志物。除非通过组织学畸形D-Score对子宫内膜增生进行分层，否则PTEN的阳性预测值较低。(c) 2005年Elsevier Inc.出版
We tested the hypothesis that PTEN inactivation may stratify cancer progression risk among putative endometrial hyperplasias, classified prognostically by means of the morphometric D score (DS). The DS, calculated from 3 morphometric variables measured in routine hematoxylin-eosin-stained endometrial biopsy slides, is the most sensitive and specific method of endometrial cancer risk prediction currently available. Clinical outcornes of 103 women with endometrial hyperplasia on biopsy were tallied according to the DS. Seven (7/103; 7%) patients with carcinoma during follow-up were all distributed within the high-risk prognostic group (ie, DS < 1 = endometrial intraepithelial neoplasia [EIN]) (7/21; 33% progression). None of the 82 cases with a DS higher than I progressed. All cases that progressed were PTEN null, indicating that this genotype is capable of further stratifying cancer progression risk in hyperplasias irrespective of histological categorization. However, only 16% of the PTEN-null cases progressed. When PTEN expression pattern was combined with EIN, the prognostic power was greatly increased (specificity from 63% for PTEN and 85% for EIN to 93% when combined; positive predictive value from 16% and 33% to 50%). We conclude that loss of PTEN expression is the first biomarker in EIN that increases the accuracy of the prognostic DS to predict cancer progression risk. Unless endometrial hyperplasias are stratified by histological inorphornetric D-Score, PTEN has a low positive predictive value. (c) 2005 Published by Elsevier Inc.