To learn more about PTEN, visit PTEN Central
PTEN immunohistochemistry should not be used at this time to make decisions about management of individual patients, as it is an insensitive (half of EIN lesions have normal PTEN expression) and nonspecific (over a third of normal proliferative and anovulatory endometria contain PTEN-null glands) marker of that group of premalignant lesions (EIN) proven to confer an increased cancer risk.
Anti-PTEN antibodies are the first commercially available “special stain” for neoplastic endometrial disease. Paraffin tissue immunohistochemistry with anti-PTEN antibody 6H2.1 (Cascade Biosciences, Winchester, MA) (1;2) shows that over half of endometrioid endometrial adenocarcinomas and their precursor EIN lesions have lost PTEN protein (3) .
(1) Perren A, Weng L, Boag A, Ziebold U, Thakore K, Dahia P et al. Immunocytochemical evidence of loss of PTEN expression in primary ductal adenocarcinomas of the breast. Am J Pathol 1999; 155:1253-1260.
(2) Gimm O, Perren A, Weng LP, Marsh DJ, Yeh JJ, Ziebold U et al. Differential Nuclear and Cytoplasmic Expression of PTEN in Normal Thyroid Tissue, and Benign and Malignant Epithelial Thyroid Tumors. Am J Pathol 2000; 156(5):1693-1700.
(3) Mutter GL, Lin MC, Fitzgerald JT, Kum JB, Baak JPA, Lees J et al. Altered PTEN expression as a diagnostic marker for the earliest endometrial precancers. J Natl Cancer Inst 2000; 92:924-930.
(4) Mutter GL, Lin MC, Fitzgerald JT, Kum JB, Ziebold U, Eng C. Changes in endometrial PTEN expression throughout the human menstrual cycle. J Clin Endocrinol Metab 2000; 85:2334-2338.
(5) Mutter GL, Chaponot M, Fletcher J. A PCR assay for non-random X chromosome inactivation identifies monoclonal endometrial cancers and precancers. Am J Pathol 1995; 146:501-508.
(6) Mutter GL, Boynton KA. X chromosome inactivation in the normal female genital tract: Implications for identification of neoplasia. Cancer Res 1995; 55:5080-5084.
(7) Jovanovic AS, Boynton KA, Mutter GL. Uteri of women with endometrial carcinoma contain a histopathologic spectrum of monoclonal putative precancers, some with microsatellite instability. Cancer Res 1996; 56:1917-1921.
(8) Mutter GL, Boynton KA, Faquin WC, Ruiz RE, Jovanovic AS. Allelotype mapping of unstable microsatellites establishes direct lineage continuity between endometrial precancers and cancer. Cancer Res 1996; 56:4483-4486.
(9) Esteller M, Catasus L, Matias-Guiu X, Mutter GL, Prat J, Baylin SB et al. hMLH1 Promoter Hypermethylation Is an Early Event in Human Endometrial Tumorigenesis. Am J Pathol 1999; 155(5):1767-1772.
(10) Mutter GL, Wada H, Faquin W, Enomoto T. K-ras mutations appear in the premalignant phase of both microsatellite stable and unstable endometrial carcinogenesis. Mol Pathol 1999; 52:257-262.
(11) Faquin WC, Fitzgerald JT, Lin MC, Boynton KA, Muto MG, Mutter GL. Sporadic microsatellite instability is specific to neoplastic and preneoplastic endometrial tissues. Am J Clin Pathol 2000; 113(4):576-582.
(12) Mutter GL. Histopathology of genetically defined endometrial precancers. Int J Gynecological Pathology 2000; 19:301-309.
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