Expression of PTEN and MUC4 May Help Predict Disease Progression in Patients with Endometriosis
MM Gondra, SM Lele, K Martin, SK Batra, S Johansson, JS Davis, S Remmenga. University of Nebraska Medical Center, Omaha, NE
Background: Molecular markers that may serve as risk factors for progression of cases with endometriosis to carcinoma have not been clearly delineated. In this study, we examined the expression of p53, PTEN and MUC4 in ovarian endometriosis associated and unassociated with ovarian borderline neoplasia/carcinoma to determine if differential expression of these genes may help in predicting disease progression.
Design: 231 consecutive cases of ovarian borderline neoplasia/carcinoma from 1996-2006 at our institution were examined for presence of concomitant endometriosis. Twenty nine cases of endometriosis without any history of ovarian neoplasia were randomly selected as controls. Expression of p53 and PTEN was studied using commercially available monoclonal antibodies. MUC4 expression was studied using a monoclonal antibody prepared in our laboratory. Immunostained slides were assessed using the H-score (summation of the product of staining intensity and proportion of cells staining) independently by two pathologists.
Results: Of the 231 cases studied 33 had concomitant endometriosis. Of these 33 cases, 13 cases of ovarian neoplasia (9 carcinoma, 4 borderline) with concomitant endometriosis had retrievable tissue for analysis. All 29 cases of ovarian endometriosis in patients without a history of ovarian neoplasia had retrievable tissue for study. None of the foci of endometriosis examined were morphologically atypical. The expression of PTEN (number of cases and H-score) was higher in the controls (62%) as compared to the cases (31% endometriosis; 8% neoplasia). More controls (79%) expressed MUC4 than cases (31% endometriosis; 46% neoplasia). Difference in expression of p53 within endometriosis was not significant between controls (20%) and cases (15%), although more tumors expressed p53 (69%).
Conclusions: Loss of PTEN and MUC4 expression likely play a role in the progression of endometriosis to neoplasia. These markers may help predict which cases of endometriosis will progress to neoplastic transformation.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 162, Tuesday Afternoon