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Stromal p16 expression differentiates endometrial polyp from endometrial hyperplasia

Virchows Archiv volume 461, pages 141–148 (2012)Cite this article

Abstract

Endometrial polyps are very common benign endometrial lesions, but their pathogenesis is poorly understood, except for a few studies indicating the possibility of benign stromal neoplasm. Although the histopathological diagnosis of endometrial polyp on a surgical specimen is straightforward, it is often difficult to differentiate endometrial polyp from endometrial hyperplasia on a biopsy or curettage specimen. Presently, there is no immunohistochemical marker helpful in this differential diagnosis. In this study, we examined p16 expression in 35 endometrial polyps and 33 cases of endometrial hyperplasia that included 16 simple hyperplasias, 14 complex atypical hyperplasias, and 3 complex hyperplasias without atypia. Stromal p16 expression differed significantly between the two groups; it was seen in 31 (89 %) endometrial polyps, but in only 1 (3 %) endometrial hyperplasia. The percentage of p16-positive stromal cells ranged from 10 to 90 % (mean, 47 %) and the positive cells tended to be distributed around glands. Six cases of endometrial hyperplasia within an endometrial polyp were also examined and all cases showed stromal p16 expression. There was no difference in glandular p16 expression between endometrial polyps 33 (94 %) and hyperplasia 27 (82 %). The p16-immunoreactivity was mostly confined to metaplastic epithelial cells in both groups. Stromal p16 expression might be a peculiar characteristic of endometrial polyp and constitute a useful marker for the diagnosis, especially in fragmented specimens from biopsy or curettage. Stromal p16 expression might be a reflection of p16-induced cellular senescence, which has been documented in several benign mesenchymal neoplasms.

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Acknowledgments

This work was supported by a grant-in-aid for clinical research from the National Hospital Organization of Japan.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Advanced Diagnosis, Division of Pathology, Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan

    Suzuko Moritani, Shu Ichihara & Masaki Hasegawa

  2. Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Akari Iwakoshi

  3. Department of Pathology, Social Insurance Chukyo Hospital, Nagoya, Japan

    Sakae Murakami & Tomoko Sato

  4. Department of Obstetrics and Gynecology, Social Insurance Chukyo Hospital, Nagoya, Japan

    Tomomitsu Okamoto

  5. Department of Pathology, Chuno Kosei Hospital, Seki, Japan

    Yoshio Mori

  6. Department of Pathology, Toyokawa Municipal Hospital, Toyokawa, Japan

    Hajime Kuhara

  7. Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA

    Steven G. Silverberg

Authors
  1. Suzuko Moritani
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  2. Shu Ichihara
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  3. Masaki Hasegawa
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  4. Akari Iwakoshi
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  5. Sakae Murakami
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  6. Tomoko Sato
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  7. Tomomitsu Okamoto
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  8. Yoshio Mori
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  9. Hajime Kuhara
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  10. Steven G. Silverberg
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Correspondence to Suzuko Moritani.

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Moritani, S., Ichihara, S., Hasegawa, M. et al. Stromal p16 expression differentiates endometrial polyp from endometrial hyperplasia. Virchows Arch 461, 141–148 (2012). https://doi.org/10.1007/s00428-012-1276-1

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  • DOI: https://doi.org/10.1007/s00428-012-1276-1

Keywords

  • Endometrial polyp
  • p16
  • Endometrial hyperplasia
  • Stromal p16 expression