ARID1A, β-Catenin and P53 Immunohistochemical Expression: Diagnostic Value in Endometrial Carcinoma and Premalignant Endometrial Lesions
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Published on: February 17, 2023
Background & Objective:
Although the role of atypical endometrial hyperplasia as a precursor lesion of endometrial carcinoma (EC) has been well documented, the molecular pathogenesis underlying malignant progression remains largely unclear. The current work aimed to evaluate the role of ARID1A, β-catenin, and p53 expression in differentiating between endometrial carcinoma and precancerous endometrial lesions.
Methods:
Forty-eight cases of endometrial carcinoma (EC) and 14 cases of atypical endometrial hyperplasia (AEH) were evaluated for immunohistochemical expression of ARID1A, β-catenin, and p53.
Results:
Combining ARID1A and β-catenin enhanced diagnostic performance. For distinguishing endometrioid carcinoma from AEH/EIN, the combination achieved a sensitivity of 70% and an accuracy of 70.5%, though with lower specificity (71.4%) than ARID1A alone. For differentiating endometrioid from non-endometrioid carcinoma, the combined markers showed higher sensitivity (86.7%) and accuracy (83.3%) but reduced specificity (77.8%) compared with ARID1A alone. The triple combination of ARID1A, β-catenin, and p53 increased specificity (92.9%) for distinguishing endometrioid carcinoma from AEH/EIN compared with individual markers or the ARID1A-β-catenin double panel, but markedly decreased sensitivity (53.3%). In contrast, for differentiating endometrioid from non-endometrioid carcinoma, the triple panel achieved superior sensitivity (87.7%), specificity (94.4%), and accuracy (91.5%) relative to each marker alone or the ARID1A-β-catenin combination.
Conclusion:
The role of ARID1A, β-catenin, and p53 in the diagnosis of endometrial carcinoma (EC) is complex, as these markers are involved in distinct but interconnected molecular pathways that contribute to tumorigenesis. Their combined analysis can help classify endometrial carcinoma subtypes and may guide personalized treatment strategies.
