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. 2024 Jul 23;16(7):e65225.
doi: 10.7759/cureus.65225. eCollection 2024 Jul.

Expression of E-cadherin in Hyperplastic Endometrium: A Retrospective Analysis

Monisha Rita Jayaraman  1 , Niveditha En  1 , Volga Harikrishnan  1
Affiliations

Expression of E-cadherin in Hyperplastic Endometrium: A Retrospective Analysis

Monisha Rita Jayaraman et al. Cureus. .

Abstract

Aim Epithelial cadherin or E-cadherin is a cell adhesion molecule that is present in all cells to promote integrity and survival of the cells. The aim of this study was to assess the immunohistochemical staining pattern of E-cadherin in hyperplastic endometrium. Methods A total of 25 blocks of formalin-fixed paraffin-embedded tissues of endometrial biopsies, from September 2020 to May 2023, were obtained from the Department of Pathology, Saveetha Medical College. Out of these 25 histologically proven cases of endometrial hyperplasia (EH), 17 cases were of EH without atypia and 8 cases were of endometrial hyperplasia with atypia (AH, or atypical hyperplasia). Results The immunohistochemical examination revealed that E-cadherin expression was downregulated in both EH without atypia and AH. But the downregulation was more pronounced in cases of AH than in EH without atypia. This was confirmed by the comparison of E-cadherin expression between EH with and without atypia by a chi-square test, which showed a p-value of 0.05 and was proven significant. Conclusion The heterogeneous expression of E-cadherin can be attributed to the impairment of cadherin-catenin complex. This impairment is seen in AH as well as EH without atypia. This shows this impairment occurs very early in the transformation process of the endometrium from hyperplastic to neoplastic.

Keywords: atypical endometrial hyperplasia; cell adhesion molecule; e-cadherin; endometrial hyperplasia; hyperplastic endometrium; premalignant conditions.

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Conflict of interest statement

Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Agewise distribution of endometrial hyperplasia with atypia and without atypia
The X axis represents age in years and Y axis represents percentage of cases. The green bar represents atypical hyperplasia and the blue bar represents endometrial hyperplasia without atypia.
Figure 2
Figure 2. Comparison of presenting symptoms in endometrial hyperplasia (EH) with atypia and without atypia
AH, atypical hyperplasia The Y axis represents percentage of cases. X axis - the blue bar represents the number of cases presenting with abnormal uterine bleeding and the green bar represents the number of cases presenting with post-menopausal bleeding.
Figure 3
Figure 3. Comparison of endometrial thickness (ET) in patients with endometrial hyperplasia (EH) with atypia and without atypia
AH, atypical hyperplasia The Y axis represents endometrial thickness. X axis - the green bar represents ET less than 10 mm and the blue bar represents ET more than 10 mm.
Figure 4
Figure 4. Hematoxylin and eosin-stained sections of atypical hyperplasia of the endometrium (A and B). Immunohistochemical staining of E-cadherin showing weak membrano-cytoplasmic positivity (C and D). Magnification: A and C, 100x; B and D, 400x
Figure 5
Figure 5. Hematoxylin and eosin-stained sections of endometrial hyperplasia without atypia (A and B). Immunohistochemical staining of the sections showing membrano-cytoplasmic staining of E-cadherin (C and D). Magnification: A and C, 100x; B and D, 400x
Figure 6
Figure 6. Hematoxylin and eosin-stained sections of endometrial hyperplasia without atypia (A and B). Immunohistochemical staining of the sections show strong membranous positivity for E-cadherin (C and D). Magnification: A and C, 100x; B and D, 400x
Figure 7
Figure 7. E-cadherin expression in endometrial hyperplasia with atypia and without atypia
The Y axis represents the percentage of cases. X axis - the blue bar represents normal expression of E-cadherin and the green bar represents downregulation of E-cadherin
See this image and copyright information in PMC

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