benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia
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Benign Endometrial Hyperplasia Sequence and Endometrial Intraepithelial Neoplasia. International Journal of Gynecological Pathology 26:103–114, Lippincott Williams & Wilkins, Baltimore 2007 International Society of Gynecological Pathologists. MODELO DUAL DE TUMOROGÉNESIS ENDOMETRIAL. - PowerPoint PPT PresentationTRANSCRIPT
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Benign Endometrial Hyperplasia Sequence and Endometrial
Intraepithelial Neoplasia
International Journal of Gynecological Pathology26:103–114, Lippincott Williams & Wilkins, Baltimore 2007 International Society of Gynecological Pathologists
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MODELO DUAL DE TUMOROGÉNESIS ENDOMETRIAL
+ CARCINOMA TIPO I:* inactivación de PTEN* Inestabilidad de microsatélites* Alteración del gen de beta-catenina* Mutación del protooncogén K-ras+CARCINOMA TIPO II:*Mutación de p53*Sobreexpresión del oncogén her2/neu
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PTEN y MSI en hiperplasias endometriales
- Se ha visto MSI en un pequeño % de hiperplasias atípicas, no en hiperplasias sin atipia
- inactivación de MLH1 por hipermetilación -MSI predice la presencia de carcinoma ( intervalo
bajo entre la adquisición de MSI y el desarrollo de carcinoma )
63% de EIN con inactivación del PTEN Comprobación de mutaciones en PTEN en
lesiones hiperplásicas
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LA INESTABILIDAD DE MICROSATÉLITES EN EL ADC ENDOMETRIAL SE ASOCIA CON CARACTERÍSTICAS
CLINICOPATOLÓGICAS QUE CONLLEVAN PEOR PRONÓSTICO (Am J Surg Pathol 2007; 31: 846-853)
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MSI y ADC ENDOMETRIAL
En el 75% del ca. endometrial asociado a HNPCC ( sde. De Lynch)
En el 25-45% de los ca. endometriales esporádicos
Fenotipo MSI mayor en el tipo endometrioide Se ha estudiado solo en los ca.
endometrioides ( 80-90% )
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FENOTIPO MSI
Mayor grado histológico Mayor invasión linfovascular Mayor invasión miometrial Mayor estadío clínico