Immunohistochemical Expression of Stromal P16 and Its Value in Differentiation between Endometrial Polyp and Endometrial Hyperplasia
Background: Endometrial polyps are common benign endometrial lesions. Its diagnosis
may not be difficult when surgical biopsy is adequate. Problem may arise when there is a
fragmented curettage specimen and inadequate clinical information about the patient, so
differentiation from endometrial hyperplasia may be difficult.
Objectives: The study evaluate the P16 immunohistochemical expression in endometrial
stromal cells in thirty cases of endometrial polyps and thirty cases of endometrial
hyperplasia that include twenty cases of simple hyperplasia without atypia and ten cases
of complex hyperplasia without atypia and whether it is useful in differentiation between
Methods: Thirty cases of endometrial polyps and thirty cases of endometrial hyperplasia
were collected from archives of histopathology department of teaching laboratories in Al
Yarmouk teaching hospital for the period from January 2014 to March 2016. Squamous
cell carcinoma of uterine cervix was stained as positive control. An H&E slide of each case
was stained and 4 μm thick sections was cut for immunohistochemistry. After dewaxing
and rehrdtating, the sections were treated in citrate buffer (10Mm, pH 6.0) in an autoclave
(121Co). Immunohistochemical staining was performed using antimouse p16INK4a
antibody (of Biogenex company) following the manufacturing's instructions. The
percentage of positive cells and the location of positive signals (nuclear or cytoplasmic)
estimated visually for both glandular and stromal components.
Results: There was highly significant difference in stromal P16 expression between
endometrial polyp which is seen in 25 out of 30 cases (83.33%) and endometrial
hyperplasia which is seen in only 4 out of 30 cases (13.33%). The positive stromal cells
tended to be distributed evenly in the stroma. There was no significant difference in the
glandular P16 expression between endometrial polyp 26 out of 30 cases (86.66%) and
endometrial hyperplasia 24 out of 30 cases (80%).
Conclusion: Stromal P16 expression could be a characteristic feature of endometrial
polyp and may reflect senescence in stromal cells of endometrial polyp induced by P16
which has been documented in many benign mesenchymal neoplasms.
Keywords: Stromal p16, Endometrial polyp, Endometrial hyperplasia.
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