The prognostic significance of PTEN expression in endometrial carcinoma has not been clear. We conducted the present study to clarify the relationship between PTEN expression and prognosis in advanced endometrial carcinoma. 4 showed that PTEN ϩ/-mice over 6 months old frequently developed endometrial carcinoma. These findings suggest that PTEN is strongly involved in the development and/or progression of endometrial carcinoma.Studies have also shown the relationship between PTEN and prognosis in several cancers, including endometrial carcinoma. However, these results are controversial. In 2 studies, loss of PTEN expression was related to poor prognosis in glioblastoma and prostate cancer. 5,6 In contrast, PTEN mutation was associated with favorable survival in endometrial carcinoma. 7 Two issues make it difficult to evaluate PTEN as a prognostic factor in endometrial carcinoma. First, because about 75% of patients with endometrial carcinoma present with stage I disease, which has a good prognosis, 8 a large number of advanced cases are needed to analyze survival rates meaningfully. Second, PTEN mutations are observed predominantly in endometrioid carcinomas and not in nonendometrioid subtypes, such as serous or clear cell, which are aggressive and have poor prognosis. [1][2][3]8 To examine the influence of PTEN, it is necessary to select endometrioid carcinoma.To clarify the prognostic significance of PTEN, we investigated the relationship between its expression and prognosis in a large number of patients with advanced endometrioid endometrial carcinoma.
MATERIAL AND METHODS
PatientsA total of 784 patients with endometrial carcinoma underwent primary treatment between 1985 and 2000 at Tottori University Hospital, Kurume University Hospital, National Defense Medical School Hospital, Jichi Medical School Hospital or Kawasaki Medical School Hospital (Japan). Of the 784 patients, 98 who met the following criteria were entered in the study: pure endometrioid carcinoma, undergoing surgical staging and positive retroperitoneal lymph nodes. All subjects underwent hysterectomy, bilateral salpingo-oophorectomy and pelvic and/or para-aortic lymphadenectomy. Postoperative treatment was performed according to each institutional protocol. As a result, 25 patients received wholepelvis and/or para-aortic irradiation and 62 patients received platinum-based chemotherapy. The remaining 11 patients did not have any treatment because of their poor physical condition. Eightyseven (88.8%) patients were in FIGO stage IIIc and 11 (11.2%) in stage IV. Mean age was 58.6 (range 30 -78) years. All patients provided informed consent for research use of their samples.
Immunohistochemic stainingA 4 m section was cut from the paraffin block of a primary uterine tumor. Each section was mounted on a silane-coated glass slide, deparaffinized and soaked for 15 min at room temperature in 0.3% H 2 O 2 /methanol to block endogenous peroxidase. A mouse anti-PTEN monoclonal antibody, PTEN A2B1 (Santa Cruz Biotechnology, Santa Cruz, CA) was applied for ...