Ruhul Quddus M, Latkovich Predrag, Castellani William J, James Sung C, Steinhoff Margaret M, Briggs Robert C, Miranda Roberto N
Department of Pathology, Women and Infants Hospital, Brown University Medical School, Providence, RI, USA.
Arch Pathol Lab Med. 2002 Apr;126(4):459-63. doi: 10.5858/2002-126-0459-EOCDIN.
Endometrioid carcinoma is often preceded by characteristic histopathologic lesions known as endometrial hyperplasia. Estrogen appears to be involved in the development of endometrioid carcinoma. Other mechanisms of endometrial carcinogenesis include mutations in p53 and PTEN tumor suppressor genes and overexpression of cyclin D1. However, the pattern of cyclin D1 expression is not well defined in normal, hyperplastic, neoplastic, and metaplastic endometrium.
Cyclin D1 immunohistochemical analysis was used to evaluate 108 fixed, paraffin-embedded endometrial biopsy specimens and uterine resections obtained from 108 patients. Specimens included proliferative and secretory endometria, simple and complex hyperplastic lesions, and endometrioid adenocarcinoma. Normal and metaplastic surface epithelia were also evaluated independently of glandular morphologic features.
Cyclin D1 was significantly overexpressed in glands with complex hyperplasia and endometrioid adenocarcinoma compared with proliferative or secretory endometrium and simple hyperplasia. Significant overexpression was also noted in papillary, syncytial, and squamous metaplasias compared with normal surface epithelium or epithelium with tubal metaplasia.
Overexpression of cyclin D1 increases from normal endometrium to hyperplasia and carcinoma, suggesting that it may play a role in endometrial carcinogenesis. Overexpression of cyclin D1 in endometrial glands was independent from overexpression of cyclin D1 in surface metaplastic epithelium.
子宫内膜样癌通常由特征性组织病理学病变即子宫内膜增生发展而来。雌激素似乎参与子宫内膜样癌的发生。子宫内膜癌发生的其他机制包括p53和PTEN肿瘤抑制基因的突变以及细胞周期蛋白D1的过表达。然而，细胞周期蛋白D1在正常、增生、肿瘤性和化生的子宫内膜中的表达模式尚未明确。
采用细胞周期蛋白D1免疫组化分析评估108例患者的108份固定、石蜡包埋的子宫内膜活检标本和子宫切除术标本。标本包括增殖期和分泌期子宫内膜、单纯性和复杂性增生性病变以及子宫内膜样腺癌。正常和化生的表面上皮也独立于腺形态学特征进行评估。
与增殖期或分泌期子宫内膜及单纯性增生相比，细胞周期蛋白D1在复杂性增生和子宫内膜样腺癌的腺体中显著过表达。与正常表面上皮或输卵管化生上皮相比，在乳头状、合体细胞性和鳞状化生中也观察到显著过表达。
从正常子宫内膜到增生和癌，细胞周期蛋白D1的过表达增加，提示其可能在子宫内膜癌发生中起作用。子宫内膜腺体中细胞周期蛋白D1的过表达独立于表面化生上皮中细胞周期蛋白D1的过表达。
