PTEN immunohistochemistry in endometrial hyperplasia: which are the optimal criteria for the diagnosis of precancer?

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
Antonio TravaglinoFulvio Zullo

Abstract

Guidelines recommend protein phosphatase and tensin homolog (PTEN) immunohistochemistry for differentiating between benign endometrial hyperplasia (BEH) and atypical endometrial hyperplasia/endometrioid intraepithelial neoplasia (AEH/EIN). However, it is unclear when PTEN expression should be defined as 'lost' and thus suggestive of AEH/EIN. We aimed to determine the optimal immunohistochemical criteria to define PTEN loss in endometrial hyperplasia, through a systematic review and meta-analysis of diagnostic accuracy. Electronic databases were searched for studies assessing immunohistochemical expression of PTEN in both BEH and AEH/EIN specimens. PTEN status ('loss' or 'presence') was the index test; histological diagnosis ('AEH/EIN' or 'BEH') was the reference standard. Accuracy was quantified based on the area under the curve (AUC) on summary receiver operating characteristic (SROC) curves, for several different thresholds of PTEN expression. Eighteen studies with 1362 hyperplasias were included. Six different criteria to define PTEN loss were assessed. Low diagnostic accuracy was found for complete loss of expression (AUC = 0.71), presence of any null gland (AUC = 0.63), positive cells <10% (AUC = 0.64), positive cells <50%...Continue Reading

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Citations

Aug 14, 2019·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Antonio TravaglinoFulvio Zullo
Oct 22, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneMaurizio Guida
Aug 25, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneMaurizio Guida
Oct 5, 2019·American Journal of Clinical Pathology·Antonio TravaglinoMassimo Mascolo
Dec 8, 2019·Pathology Oncology Research : POR·Antonio TravaglinoFulvio Zullo
May 31, 2020·Pathology Oncology Research : POR·Antonio TravaglinoFulvio Zullo
Aug 25, 2019·Pathology Oncology Research : POR·Antonio RaffoneGian Franco Zannoni
Mar 18, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Antonio RaffoneFulvio Zullo
Sep 23, 2019·Archives of Gynecology and Obstetrics·Ruggero LionettiFrancesco Corcione
Sep 19, 2019·Archives of Gynecology and Obstetrics·Antonio TravaglinoFulvio Zullo
Feb 23, 2020·American Journal of Clinical Pathology·Antonio TravaglinoMassimo Mascolo
Jun 17, 2019·Pathology Oncology Research : POR·Antonio RaffoneFulvio Zullo
Dec 20, 2019·Applied Immunohistochemistry & Molecular Morphology : AIMM·Antonio TravaglinoFulvio Zullo
Apr 17, 2020·Archives of Gynecology and Obstetrics·Antonio TravaglinoFulvio Zullo
Jun 20, 2020·Pathology Oncology Research : POR·Antonio TravaglinoMassimo Mascolo
Aug 23, 2019·American Journal of Clinical Pathology·Antonio TravaglinoFulvio Zullo
Jun 27, 2019·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Antonio RaffoneFulvio Zullo
Apr 8, 2020·Archives of Gynecology and Obstetrics·Antonio TravaglinoFulvio Zullo
Mar 28, 2019·Archives of Gynecology and Obstetrics·Antonio RaffoneFulvio Zullo
Sep 2, 2019·Gynecologic Oncology·Antonio RaffoneFulvio Zullo
Oct 17, 2019·Cold Spring Harbor Perspectives in Medicine·Nahal HaddadiDeborah J Marsh
Jan 15, 2020·Gynecologic Oncology·Antonio RaffoneFulvio Zullo
Feb 24, 2020·Pathology, Research and Practice·Antonio TravaglinoMassimo Mascolo
Feb 23, 2021·Pathology, Research and Practice·Antonio TravaglinoMassimo Mascolo
Apr 1, 2021·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Antonio TravaglinoLuigi Insabato
Sep 22, 2020·Pathology, Research and Practice·Raduan Ahmed FrancaMassimo Mascolo
Aug 8, 2021·Hormone Molecular Biology and Clinical Investigation·Mohamad Nasir ShafieeReena Rahayu Md Zain

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