Precursors Of Nonendometrioid Endometrial Adenocarcinoma

Papillary serous carcinoma is the prototypical example of nonendometrioid endome-trial adenocarcinoma, a group that also includes clear cell and carcinosarcoma histo-types (50). Many papillary serous tumors have lost estrogen and progesterone receptors (51), and there are no known hormonal exposures, which increase risk for this variety of carcinoma. Loss of p53 normal function, seen by aberrant immunohistochemical accumulation of the inactivated protein, is a diagnostically useful marker for very scanty or poorly preserved specimens, where a differential diagnosis between surface reactive

Fig. 5. (Opposite page) Physiological changes in PTEN expression during the normal menstrual cycle. Endometrial gland expression of PTEN is the greatest in an estrogen-dominated environment (proliferative endometrium, Panel A) and diminishes after several days of progestin exposure (24 day secretory endometrium, Panel B). Stromal PTEN expression is high throughout. Physiological requirements for the tumor suppressor function of PTEN under varying hormonal conditions is one mechanism whereby the systemic hormonal environment may act as a positive or negative selection factor for PTEN mutant glands. PTEN immunohistochemistry with antibody 6h2.1.

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