Stromal p16 and SATB2 Expression Does Not Distinguish Atypical Polypoid Adenomyoma (APA) From its Benign Mimics.

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-11-01 Epub Date: 2024-05-29 DOI:10.1097/PGP.0000000000001023
Chau Minh Bui, Mahzad Azimpouran, Bonnie Balzer, Horacio Maluf, Fabiola Medeiros
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Abstract

Atypical polypoid adenomyoma (APA) is a polypoid biphasic lesion of low malignant potential that arises in the lower uterine segment and uterine corpus. The diagnosis of APA is often challenging on biopsy and curettage specimens, and both benign and malignant processes need to be considered in the differential. Stromal expression of p16 and SATB2 have recently been shown to distinguish APA from myoinvasive endometrioid carcinoma. The authors hypothesized that p16 and SATB2 immunohistochemistry could also aid in the distinction of APA from benign adenomyomatous polyp and endometrioid adenomyoma. The study comprised 10 APAs, 7 adenomyomatous polyps, 11 endometrioid adenomyomas, and 10 myoinvasive endometrioid carcinomas. The majority of APAs showed moderate to strong, diffuse p16 and stromal expression. However, most adenomyomatous polyps and endometrioid adenomyomas also exhibited moderate to strong, focal to diffuse p16 stromal expression. SATB2 showed weak to moderate, focal to diffuse expression in the majority of APAs, adenomyomatous polyps and endometrioid adenomyomas. In contrast, p16 and SATB2 were negative to weak and focal in 90% of myoinvasive endometrioid carcinomas. Our findings demonstrate that p16 and SATB2 may be helpful in the differential diagnosis of myoinvasive endometrioid carcinoma and APA while not useful in separating APA from adenomyomatous polyp and endometrioid adenomyoma.

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基质 p16 和 SATB2 表达不能区分非典型多形性腺肌瘤 (APA) 和良性拟态腺肌瘤。
非典型多形性腺肌瘤(APA)是一种多形性双相病变,恶性程度较低,发生于子宫下段和子宫体。活检和刮宫标本对 APA 的诊断往往具有挑战性,在鉴别时需要考虑良性和恶性过程。最近有研究表明,p16 和 SATB2 的基质表达可将 APA 与肌浸润性子宫内膜样癌区分开来。作者假设 p16 和 SATB2 免疫组化也能帮助区分 APA 与良性腺肌瘤性息肉和子宫内膜样腺肌瘤。研究包括 10 例 APA、7 例腺肌瘤性息肉、11 例子宫内膜样腺肌瘤和 10 例肌浸润性子宫内膜样癌。大多数 APA 显示中度至高度弥漫性 p16 和基质表达。然而,大多数腺肌瘤性息肉和子宫内膜样腺肌瘤也表现出中度到高度、局灶性到弥漫性的p16基质表达。在大多数 APA、腺肌瘤性息肉和子宫内膜样腺肌瘤中,SATB2 表现为弱至中度、灶性至弥漫性表达。相反,在90%的肌浸润性子宫内膜样癌中,p16和SATB2呈阴性至弱表达,且呈局灶性表达。我们的研究结果表明,p16和SATB2可能有助于肌浸润性子宫内膜样癌和APA的鉴别诊断,但无助于将APA与腺肌瘤性息肉和子宫内膜样腺肌瘤区分开来。
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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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