Department of Pathology, University of Washington Medical Center Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Int J Gynecol Pathol. 2012 Mar;31(2):151-159. doi: 10.1097/PGP.0b013e318226b376.
Immunohistochemical markers to assist in the diagnosis and classification of hyperplastic endometrial epithelial proliferations would be of diagnostic use. To examine the possible use of PAX2 as a marker of hyperplastic endometrium, cases of normal endometrium, simple and complex hyperplasia without atypia, atypical hyperplasia, and International Federation of Gynecology and Obstetrics (FIGO) grade 1 endometrioid carcinomas were stained for PAX2. Two hundred and six endometrial samples were available for interpretation of PAX2 staining. The percentage of cases with complete PAX2 loss (0% of cells staining) increased with increasing severity of hyperplasia: 0% of normal proliferative and secretory endometrium (n=28), 17.4% of simple hyperplasia (n=23), 59.0% of complex hyperplasia (n=83), 74.1% of atypical hyperplasia (n=54), and 73.3% of FIGO grade 1 endometrioid cancers (n=15). Partial loss of PAX2 expression did occur in normal endometrium (17.9%) but in smaller proportions of tissue and was less frequent than in simple hyperplasia (47.8% with partial loss), complex hyperplasia (32.5%), atypical hyperplasia (22.2%), and FIGO grade 1 carcinomas (20.0%). Uniform PAX2 expression was rare in complex (8.4%) and atypical hyperplasia (3.7%) and carcinoma (6.7%). When evaluating loss of PAX2 in histologically normal endometrium adjacent to lesional endometrium in a given case, statistically significant differences in staining were observed for simple hyperplasia (P=0.011), complex hyperplasia (P<0.001), atypical hyperplasia (P<0.001), and FIGO grade 1 endometrioid cancer (P=0.003). In summary, PAX2 loss seems to occur early in the development of endometrial precancers and may prove useful in some settings as a diagnostic marker in determining normal endometrium from complex and atypical hyperplasia and low-grade carcinomas. However, it is not useful in distinguishing between these diagnostic categories.
免疫组织化学标志物有助于诊断和分类增生性子宫内膜上皮增生，具有诊断价值。为了研究 PAX2 作为子宫内膜增生标志物的可能用途，对正常子宫内膜、无非典型单纯性和复杂性增生、非典型增生以及国际妇产科联合会（FIGO）分级 1 子宫内膜样癌进行了 PAX2 染色。共有 206 例子宫内膜样本可用于解释 PAX2 染色。完全丧失 PAX2（无细胞染色）的病例百分比随着增生程度的增加而增加：正常增殖和分泌期子宫内膜（n=28）为 0%，单纯性增生（n=23）为 17.4%，复杂性增生（n=83）为 59.0%，非典型增生（n=54）为 74.1%，FIGO 分级 1 子宫内膜样癌（n=15）为 73.3%。PAX2 表达部分缺失确实发生在正常子宫内膜（17.9%），但组织中的比例较小，且比单纯性增生（47.8%）、复杂性增生（32.5%）、非典型增生（22.2%）和 FIGO 分级 1 癌（20.0%）更为少见。复杂（8.4%）和非典型增生（3.7%）和癌（6.7%）中 PAX2 表达均匀罕见。在评估给定病例中病变子宫内膜相邻的组织学正常子宫内膜中 PAX2 的缺失时，单纯性增生（P=0.011）、复杂性增生（P<0.001）、非典型增生（P<0.001）和 FIGO 分级 1 子宫内膜样癌（P=0.003）之间存在统计学显著差异。总之，PAX2 缺失似乎发生在子宫内膜癌前病变的早期发展过程中，并且在某些情况下作为诊断标志物，在区分复杂和非典型增生以及低级别癌与正常子宫内膜方面可能有用。然而，它在区分这些诊断类别方面并不有用。
