TY - JOUR
T1 - Histopathologic diagnosis of endometrial precancers
T2 - Updates and future directions
AU - Chen, Hao
AU - Strickland, Amanda L.
AU - Castrillon, Diego H.
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2022/5
Y1 - 2022/5
N2 - Early detection of endometrial cancer, especially its precancers, remains a critical and evolving issue in patient management and the quest to decrease mortality due to endometrial cancer. Due to many factors such as specimen fragmentation, the confounding influence of endogenous or exogenous hormones, and variable or overlapping histologic features, identification of bona fide endometrial precancers and their reliable discrimination from benign mimics remains one of the most challenging areas in diagnostic pathology. At the same time, the diagnosis of endometrial precancer, or the presence of suspicious but subdiagnostic features in an endometrial biopsy, can lead to long clinical follow-up with multiple patient visits and serial endometrial sampling, emphasizing the need for accurate diagnosis. Our understanding of endometrial precancers and their diagnosis has improved due to systematic investigations into morphologic criteria, the molecular genetics of endometrial cancer and their precursors, the validation of novel biomarkers and their use in panels, and more recent methods such digital image analysis. Although precancers for both endometrioid and non-endometrioid carcinomas will be reviewed, emphasis will be placed on the former. We review these advances and their relevance to the histopathologic diagnosis of endometrial precancers, and the recently updated 2020 World Health Organization (WHO) Classification of Female Genital Tumors.
AB - Early detection of endometrial cancer, especially its precancers, remains a critical and evolving issue in patient management and the quest to decrease mortality due to endometrial cancer. Due to many factors such as specimen fragmentation, the confounding influence of endogenous or exogenous hormones, and variable or overlapping histologic features, identification of bona fide endometrial precancers and their reliable discrimination from benign mimics remains one of the most challenging areas in diagnostic pathology. At the same time, the diagnosis of endometrial precancer, or the presence of suspicious but subdiagnostic features in an endometrial biopsy, can lead to long clinical follow-up with multiple patient visits and serial endometrial sampling, emphasizing the need for accurate diagnosis. Our understanding of endometrial precancers and their diagnosis has improved due to systematic investigations into morphologic criteria, the molecular genetics of endometrial cancer and their precursors, the validation of novel biomarkers and their use in panels, and more recent methods such digital image analysis. Although precancers for both endometrioid and non-endometrioid carcinomas will be reviewed, emphasis will be placed on the former. We review these advances and their relevance to the histopathologic diagnosis of endometrial precancers, and the recently updated 2020 World Health Organization (WHO) Classification of Female Genital Tumors.
KW - Endometrial atypical hyperplasia (AH)
KW - Endometrial cancer
KW - Endometrial precancer
KW - Endometrioid intraepithelial neoplasia (EIN)
KW - Pax2
KW - Pten
KW - β-catenin
UR - http://www.scopus.com/inward/record.url?scp=85121691370&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85121691370&partnerID=8YFLogxK
U2 - 10.1053/j.semdp.2021.12.001
DO - 10.1053/j.semdp.2021.12.001
M3 - Review article
C2 - 34920905
AN - SCOPUS:85121691370
SN - 0740-2570
VL - 39
SP - 137
EP - 147
JO - Seminars in Diagnostic Pathology
JF - Seminars in Diagnostic Pathology
IS - 3
ER -