Value of H-TERT and CD10 in differentiating endometrial carcinoma from atypical endometrial hyperplasia: an immunohistochemical study

Context: The histopathological differentiation between atypical endometrial hyperplasia and well-differentiated conventional endometrial carcinoma is sometimes tricky, particularly in endometrial dilatation and curettage specimens, to the extent that a differentiating marker is sought. Aim: This study was devoted to evaluate the immunohistochemical expression of CD10 and human telomerase reverse transcriptase (H-TERT) in atypical endometrial hyperplasia and endometrial carcinoma to determine their role in differentiating both lesions. Patients and methods: Thirty paraffin blocks of endometrial biopsy distributed as 15 cases of atypical endometrial hyperplasia and 15 cases of conventional endometrial carcinoma were studied immunohistochemically using antibodies against CD10 and H-TERT. Data were represented as mean, SD, and percentage. The Fisher exact test was used to compare immunoexpression between atypical endometrial hyperplasia and endometrial carcinoma. The Mann–Whitney U-test and the Kruskal–Wallis test were used to compare between the two marker expressions in both lesions. The one-way analysis of variance test was used to determine whether the difference was significant. A P-value of less than 0.05 was considered significant. Results: A statistically significant difference was observed between CD10 and H-TERT expression in both lesions, but only H-TERT significantly correlated with international federation of gynecology and obstetrics (FIGO) tumor grades in endometrial carcinoma cases. Although H-TERT labeling index upregulates with CD10 weaker expression, the relation between the two markers was not significant. Conclusion: Both CD10 and H-TERT may be involved in the progression from the atypical endometrial hyperplasia to endometrial carcinoma as well as to differentiate between the two lesions. However, only H-TERT may be associated with the prognosis of endometrial carcinoma.