Endometrial carcinoma associated with hyperplasia - Immunohistochemical study of angiogenesis and p53 expression

Objective. To clarify the hypothesis that there are two pathways of endomet rial carcinogenesis we compared the frequency of abnormal p53 protein expre ssion and angiogenesis in endometrial carcinomas with and without hyperplas ia. Methods. Specimens obtained from 70 patients with stage I-IV endometrial ca rcinomas were available for this immunohistochemical study. Immunohistochem ical staining for factor VIII-related and p53 antigens was performed using a standard immunoperoxidase technique (Histofine SAB-PO Kit, Nichirei Co., Tokyo, Japan). Microvessels were highlighted by staining endothelial cells for factor VIII-related antigen, and microvessel density (MVD) was counted in a x200 field (0.785 mm(2) per field) in the area of most active neovascu larization. p53 protein was detected with monoclonal anti-p53 antibodies (c lone DO-7, Dako, Santa Barbara, CA). Results. Twenty-six of 73 (37%) patients had hyperplasia in the endometrium adjacent to the carcinoma. Significantly more patients with low MVD (less than 60) had carcinoma with hyperplasia than those with carcinoma without h yperplasia (P = 0.0053). p53 expression was noted in a carcinomatous area i n 8 of 26 patients (30.8%) with hyperplasia compared to 26 of 44 (59.1%) wi thout hyperplasia, and the difference was statistically significant (P = 0. 0220). Conclusion. The presence or absence of hyperplasia is a different pathogene sis and important in assessing the biological behavior of endometrial carci noma, especially concerning angiogenesis and p53 expression. (C) 1999 Acade mic Press.