Evaluation of Endometrial Carcinoma and Precancers by Combined Beta_catenin and Pax-2 Immunohistochemistry
Nadwa Subhi Alazzo, Zainab Waleed Aziz, Ali Nazar Majeed QibiAbstract
Background:
Endometrial cancer (EC) is a common neoplasm. It is often preceded by atypical endometrial hyperplasia. Earlier and accurate histological diagnosis of those precursors might require the use of an immune marker panel.
Objectives:
To evaluate the expression status of beta-catenin and Pax-2 in various endometrial samples ranging from cyclical endometrium, hyperplasia with or without atypia, to endometrial carcinoma and to correlate the marker expression with some pathological parameters.
Materials and Methods:
A case-series study was performed on 40 women who underwent dilation and curettage and or hysterectomy at ALKhansaa Teaching Hospital. The specimens were divided into four groups: cyclical endometrium, endometrial hyperplasia with no atypia, endometrial hyperplasia with atypia/endometrial intraepithelial neoplasia, and endometrial carcinoma group. B-catenin and Pax-2 immunohistochemical expressions were evaluated on a representative paraffin block. The results were statistically analyzed.
Results:
The patient ages ranged from 30 to74 years with a mean of 52.36. B-catenin shows simultaneous strong membranous and cytoplasmic staining in all precancerous endometrial hyperplasia and 80% of endometrial carcinoma. Pax-2 nuclear staining was completely lost in 86.6% of endometrial carcinoma cases. The aberrant co-expression of B-catenin/Pax-2 in endometrial carcinoma was predominantly identified in Grade 2 endometrial carcinoma, (
Conclusion:
Beta-catenin and Pax-2 can effectively detect precancerous and endometrial carcinoma, especially when used in panels. These findings give further evidence of the diagnostic accuracy of both markers in clinical practice and their applicability in cases with atypical presentations.