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Benign Endometrial Hyperplasia Sequence and Endometrial Intraepithelial Neoplasia

Benign Endometrial Hyperplasia Sequence and Endometrial Intraepithelial Neoplasia. International Journal of Gynecological Pathology 26:103–114, Lippincott Williams & Wilkins, Baltimore 2007 International Society of Gynecological Pathologists. MODELO DUAL DE TUMOROGÉNESIS ENDOMETRIAL.

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Benign Endometrial Hyperplasia Sequence and Endometrial Intraepithelial Neoplasia

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  1. Benign Endometrial Hyperplasia Sequence and EndometrialIntraepithelial Neoplasia International Journal of Gynecological Pathology 26:103–114, Lippincott Williams & Wilkins, Baltimore 2007 International Society of Gynecological Pathologists

  2. MODELO DUAL DE TUMOROGÉNESIS ENDOMETRIAL + CARCINOMA TIPO I: * inactivación de PTEN * Inestabilidad de microsatélites * Alteración del gen de beta-catenina * Mutación del protooncogén K-ras +CARCINOMA TIPO II: *Mutación de p53 *Sobreexpresión del oncogén her2/neu

  3. PTEN y MSI en hiperplasias endometriales • - Se ha visto MSI en un pequeño % de hiperplasias atípicas, no en hiperplasias sin atipia • - inactivación de MLH1 por hipermetilación • -MSI predice la presencia de carcinoma ( intervalo bajo entre la adquisición de MSI y el desarrollo de carcinoma ) • 63% de EIN con inactivación del PTEN • Comprobación de mutaciones en PTEN en lesiones hiperplásicas

  4. LA INESTABILIDAD DE MICROSATÉLITES EN EL ADC ENDOMETRIAL SE ASOCIA CON CARACTERÍSTICAS CLINICOPATOLÓGICAS QUE CONLLEVAN PEOR PRONÓSTICO (Am J Surg Pathol 2007; 31: 846-853)

  5. MSI y ADC ENDOMETRIAL • En el 75% del ca. endometrial asociado a HNPCC ( sde. De Lynch) • En el 25-45% de los ca. endometriales esporádicos • Fenotipo MSI mayor en el tipo endometrioide • Se ha estudiado solo en los ca. endometrioides ( 80-90% )

  6. FENOTIPO MSI • Mayor grado histológico • Mayor invasión linfovascular • Mayor invasión miometrial • Mayor estadío clínico

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