Early detection of malignant changes in premalignant endometrial and cervical lesions using P53 immunostaining and cytophotometric study of DNA nuclear content

ABSTRACT

Early detection of malignant changes in premalignant lesions of both endometrium and cervix, using P53 nuclear immunostaining and cytophotometric technique for DNA nuclear contents. Forty seven endometrial and cervical biopsies from patients suffering of pre or postmenopausal bleeding [18 simple and complex endometrial hyperplasia with atypia 10 CIN, 12 endometrial carcinoma, and 7 cervical carcinoma] and 12 control cases were evaluated by histopathology, P53 immunostaining and DNA cytophotometric study. Three cases [one simple, 2 complex] out of 18 atypical endometrial hyperplasia [16.7%] were aneuploid and showed positive P53 immunostaining [malignant criteria]. Two cases out of 10 CIN [20%] were aneuploid and 4 were positive P53 immuno-staining [40%]. Aneuploidy and P53 immunostaining were directly proportional to the tumour grade in both endometrial and cervical carcinoma with increasing aneuploidy and staining positivity in higher than lower tumour grades. Adding P53 immunostaining or cytophotometric study to histopathology in cases of atypical simple and complex endometrial hyperplasia and CIN will help in early detection of malignant changes for better operative and post operative management. Both methods may help in measurement of the power of invasion and tumour aggressiveness in frank endometrial and cervical malignancy for better evaluation of operative and postoperative management