Analysis of PTEN, estrogen receptor  and progesterone receptor expression in endometrial hyperplasia using tissue microarray

We compared the immunohistochemical expression of PTEN, estrogen receptor  (ER-) and progesterone receptor (PR) in a series of endometrial hyperplasia (EH) and in disordered proliferative endometrium (DPE) by tissue microarray (TMA). The material consisted of 141 endometrial curretings including 98 cases (study group) diagnosed as EH [59-simple (SH), 20-complex (CH), 19 atypical (AEH)] and 43 cases (control group) with DPE due to anovulation. The mean PTEN expression index decreased in order DPE-EH-AEH groups (p < 0.05). The mean value of the ER- index increased in order DPE-SH-CH and decreased in AEH group, whereas the PR expression index decreased in order DPE-EH-AEH (p > 0.05 and p > 0.05, respectively). These results show that steroid hormone receptor status influences the architectural changes of endometrium rather than cytological ones. On the other hand, decreased PTEN expression correlates more closely with the cytological atypia in endometrial cells. In our opinion ER- and PR may be useful markers predicting therapy response in EH. PTEN presents as a strong prognosticator which may help in determining the risk of progression in advanced stages of EH, especially those with atypical cytological features.