الفهرس 
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Abstract
Summary and Conclusion
A total number of 52 cases of endometrial lesions, benign
and malignant, were studied histopathologically (for typing of the
lesion, grading of the tumors, detection of mean apoptotic index in
different lesions, and other histopathological changes in different
grades) and inmmunohistochemically for localization of HIlT gene
in malignant and premalignant lesions in relation to tumor behavior
as histopathological type, tumor grade and any available data. The
cases were selected to represent a spectrum of endometrial changes
including proliferative phase (n=8), secretory phase (n=2); simple
hyperplasia (n= 10), complex hyperplasia (n= 10), atypical
hyperplasia (n=8); and various grades of endometrioid carcinoma,
GI (n=9), Gil (n=8), and GIll (n=7).
This study revealed that HIlT was strongly expressed in 100%
of cases of proliferative, secretory phases of the menstrual cycle as
well as simple and complex hyperplasia but reduced in 25% of cases
of atypical hyperplasia. This may indicate that alteration of the FHIT
gene is an early event in carcinogenesis of the endometrium.
Concerning adenocarcinoma of the endometrium, 54.2% of
cases revealed reduced pFHIT expression with significant
progressive reduction with higher histological grade of the tumor.
FHIT protein expression was markedly down regulated in
adenocarcinoma of the endometrium when compared to normal and
hyperplastic endometrium with a significant statistical difference
(p<O.Ol).
-150- summary and Conclusion
The distribution of the marker was carefully examined to detect
different immunohistochemical localizations for each lesion, From
which, pFHIT expression was found to be helpful in differentiation
between some cases of atypical endometrial hyperplasia and
complex hyperplasia (pure apical stain in 50% of cases of atypical
hyperplasia only); GIl adenocarcinoma from GI (by the appearance
of nuclear together with cytoplasmic stain starting from GIl), and
GIll (by appearance of pure nuclear stain in 28.6% of cases only in
GIll) (p< 0.05).
This study revealed the importance of pFHIT expression ill
differentiation between some cases of atypical hyperplasia (reduced
in 25% of cases) and complex hyperplasia. While, apoptotic index
showed no significant difference between the two types of
hyperplasia.
In endometrioid carcinoma, it was found that higher grades was
associated with higher MAl (P< 0.01), with significant correlation
between FHIT expression and the apoptotic index (p<0.01).
In the current study, we found that high grades of endometrioid
carcinoma was associated with less desmoplastic reaction (P<0.05)
which was significantly correlated with FHIT expression; and more
vascular invasion (P<0.05) which was inversely correlated with FHIT
expression.
While, it was found that there was no significant correlation
between the grade and heavy lymphocytic infiltration (p> 0.05) or
tumor necrosis (p>0.05); both showed insignificant correlation with
FHIT expression.
-151- Summary and Conclusion
It was concluded from this study that pFIllT expression could be
helpful in differentiation of different endometrial lesions by its
expression and localization. Also, FIllT abnormalities provide an
opportunity for accumulating genetic mutation and evolution from a
precursor lesion to invasive carcinoma. Further studies are
recommended to study pFIllT expression in a larger number of
cases to define its importance in endometrial adenocarcinoma and
other types of endometrial carcinomas and sarcoma and to
investigate its expression as a prognostic marker for treatment in
endometrial carcinomas.
-152- Summary and Conclusion