Pathological Scoring of PTEN Immunohistochemistry in Endometrial Carcinoma: Diagnostic, Prognostic and  Therapeutic Efficacy

Bidyut Prabha Satpathy; Sonali Kar; Sugatha Sahu

doi:10.51168/sjhrafrica.v5i6.1256

Authors

Bidyut Prabha Satpathy Assistant Professor, Department of Pathology, IMS & SUM Hospital, Bhubaneswar, Odisha, India
Sonali Kar Assistant Professor, Department of Pathology, IMS & SUM Hospital, Bhubaneswar, Odisha, India.
Sugatha Sahu Assistant Professor, Department of Pathology, IMS & SUM Hospital, Bhubaneswar, Odisha, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i6.1256

Keywords:

Endometrial Carcinoma, PTEN, Immunohistochemistry, Prognostic Marker, Myometrial Invasion

Abstract

Background: Endometrial carcinoma is the most common gynecologic malignancy worldwide, with a rising incidence, especially among postmenopausal women. The identification of reliable prognostic markers is crucial for improving early diagnosis and patient management. PTEN (Phosphatase and TENsin homolog), a tumor suppressor gene, has been frequently associated with endometrial carcinoma, highlighting its potential as a diagnostic and prognostic marker. This study aims to evaluate the expression of PTEN in endometrial tissues diagnosed with hyperplasia and carcinoma, and to correlate PTEN expression with the type and grade of endometrial carcinoma.

Methods: Endometrial tissue samples from 66 patients were analyzed, including 30 cases of endometrioid endometrial carcinoma (EEC), 12 cases of proliferative endometrium (PE), 12 cases of endometrial hyperplasia (EH), and 12 cases of non-endometrioid uterine malignancies (NEUM). PTEN expression was assessed using immunohistochemistry on paraffin-embedded tissue sections, and statistical analysis was performed using SPSS software version 20.

Results: PTEN expression was significantly lower in EEC compared to PE and EH (p = 0.0001). The mean PTEN scores were 235.83 ± 26.79 for PE, 94.17 ± 61.27 for EH, 31.67 ± 58.37 for EEC, and 61.67 ± 79.64 for NEUM. A significant correlation was found between reduced PTEN expression and higher tumor grade, increased myometrial invasion, and advanced tumor stage (p < 0.05).

Conclusion: PTEN expression is significantly reduced in endometrial carcinoma, particularly in higher-grade tumors and those with extensive myometrial invasion. This study underscores the potential of PTEN as a prognostic marker in endometrial carcinoma, which could be instrumental in guiding treatment strategies.

Recommendations: Further studies with larger sample sizes are recommended to validate PTEN as a routine diagnostic and prognostic marker in clinical practice. Additionally, exploring the role of PTEN in targeted therapies could provide new avenues for the treatment of endometrial carcinoma.