P53 expression in adenomyosis in endometrial carcinoma patients.

Histopathologic changes ranging from simple cystic hyperplasia to carcinoma in situ may be observed in adenomyotic foci in patients with endometrial carcinoma. These changes can be an area of concern and physicians should be aware of their clinicopathologic significance. We studied a total of 94 patients, including endometrial carcinoma with (28 patients) and without adenomyosis (56 patients), and control group of adenomyosis cases (10 patients) without endometrial carcinoma. The histopathological changes in adenomyosis in patients with endometrial carcinoma varied from endometrial glands resembling the basal endometrium (13 of 28) through simple hyperplasia (8 of 28) to complex atypical hyperplasia, resembling carcinoma in situ (7 of 28). Formalinfixed paraffin-embedded tissues from 55 patients (45 endometrial carcinomas and 10 control adenomyosis) were stained with monoclonal antibodies against P53. P53 positivity was not detected in adenomyosis cases without endometrial carcinoma but was present in 7 of the endometrial carcinoma-related cases. P53 positivity was found in 14 of 45 endometrial carcinomas studied. In all of the adenomyosis-positive cases, the endometrium was also positive. In conclusion, adenomyosis with a range of hyperplastic to atypical changes is not uncommon in adenocarcinoma patients. Our findings regarding P53 positivity in adenomyosis are consistent with the hypothesis that hyperplastic and atypical changes in adenomyosis might be due to a carcinogenic field effect in the vicinity of endometrial carcinoma rather than by direct invasion.