Study of the association of phosphatase and tensin homolog and p27 expressions in endometrial hyperplasia and carcinoma

Introduction: Phosphatase and tensin homolog (PTEN) and p27 are commonly mutated gene in endometrial carcinoma (EC) and their association in development of EC has not been fully understood. The Aim of the Study: The aim is to clarify the association of PTEN and p27 in EC and their correlation with the histologic grade. Material and Methods: Paraffin-embedded 20 and 50 specimens representing EH and EC were collected, cut into 4 mm thick and stained with H&E stain for histopathological examination. All EC cases were graded according to the percentage of nonsquamous solid pattern into 3 grades. Immunohistochemical (IHC) analyses were done using a rabbit polyclonal anti-PTEN antibody and a rabbit monoclonal anti-p27 antibody. Evaluation of reactivity was categorized: 1+ (weak) = less than 10%, 2+ (moderate) = 11 to 50% and 3+ (strong) = more than 50% tumor. t-test, one way ANOVA and chi-square test were used in the statistical analysis. Results: Loss of PTEN was seen in 7/20 (35%) and 29/50 (58%) of EH and EC cases with significance (P =0.01824), opposite to 17/20 (85%) and 25/50 (50%) of p27 (P = 0.00334). Both antibodies showed significance in EH cases only (P= 0.00019). No correlation with the histological grade for both antibodies. Four major categories were formulated; PTEN+/p27+ (n= 2, 14, 10%, 28%), PTEN+/p27- (n = 5, 7; 25% and 14%), PTEN-/p27+ (n= 1, 11; 5%, 22%) PTEN-/p27- (n= 12, 18; 60%, 36%) cases of EH and EC, respectively with no significant difference obtained. Conclusion: Not all cases of PTEN negative EC showing p27 loss and vice versa. Despite many studies reacted with PTEN and p27 expression in EC, none of them is confirmatory to adjust the correlation between them in EC. So, more studies must be done to correlate between the degree of PTEN loss and p27 comprising all subtypes and grading of EC.