Endometrioid adenocarcinoma Figo grade 1: Trying to understand this

You should ask your Dr, but here's my impression. These are immunohistochemistry (IHC) results, where they stain your specimen on a microscope slide with antibodies that interact with the specific proteins being reported. Anywhere in the specimen where that protein is present turns brown. This brown stain is measured semi-quantatively (usually by computer), where 3+ is the highest level.

ER and PR are the estrogen and progesterone receptors. Having high levels of these is common in low grade endometrial cancers. P53 is a protein that is present at aberrant levels in high grade ECs. "Wild-type" is scientist-speak for "normal". Wild-type p53 is good, since it is consistent with a low grade EC. PTEN is a gene that is very frequently lost in low grade ECs, so this is also consistent with yours being low grade.

I don't know much about the other two. PAX2 is a protein that, according to Google, is lost when a endometrial precancer turns into a cancer. I'm not sure whether the pattern described for beta-catenin is normal or not. My tumor has never been analyzed for beta-catenin or PAX2.

@tdavenport, what did you learn at your follow-up appointment? How are you doing?

really not much of anything. questions I asked her she just replied “we won’t know until after the surgery, “

i go for bloodwork this friday and then feb 28 is my surgery.

I asked about those results and she just said that is just results from your tumor.

she didn’t say anything like it is low grade or what she thought about it.

she said if i had too much scar tissue it would be an open surgery( i had a gallbladder surgery a few years ago and they tried the robot surgery but wasn’t able to do it)

so i am just anxious and worried

Did the the pathology report on the biopsy say "FIGO grade 1"? If so, at least the part of the tumor they biopsied was low grade (grade 1 is the lowest grade.). Waiting is the definitely worst part, but soon the day of the surgery will come and it will be over.

yes it said that waiting is the worst and worrying about the pain of the surgery too. how my body will be changed etc all of that

@tdavenport I was diagnosed with endometroid adenocarcinoma, FIGO Grade 1 in 2019. I was scheduled for a hysterectomy and like you I found that the waiting was difficult. I didn't know what was going to happen the day of the hysterectomy although my surgeon did tell me that unless there were complications it would be same-day surgery. I spent several hours in a private room of the hospital (Methodist Hospital at Mayo Clinic in Rochester) where I had a very helpful, kind, and informative nurse. When I was taken to the pre-operative area to await surgery the nurses and all of the staff were kind. One thing that sticks out in my mind is that the nurse who started my IV asked me drape my arm over the bed and she then knelt down and started my IV that way. She told me that this method would be easier for me and she was so right. I've had many IVs started since then and this was the easiest and most comfortable. When I arrived in the OR and was lying on the table awaiting anesthesia my surgeon came into the room. I didn't see her but she touched my hand, and told me in a soft voice that she was present. I didn't have pain from the surgery itself and was discharged the same day. I followed all of the recommendations/instructions from the nurse in pre-op and my surgeon. I was staged at 1a and I had a followup with my surgeon 6 weeks after surgery. I was fatigued after the surgery because I had general anesthesia and I couldn't drive my car for about a week. I would say it took about 2-3 weeks before my energy returned.

Your diagnosis is the same as mine and I hope your surgery goes as smoothly as mine.

Will you see your surgeon again before surgery?

Hi,
thank you so much, what I am worried about it said PTEN loss, and all the Dr. Google I have read about is concerning to me. the other parts of it seemed okay,
Guess I will find out in a few weeks.
Thanks for the support,
Tawsha

@tdavenport. I understand your worry about information in your pathology report that is difficult to understand. I'm sorry I cannot be more helpful about PTEN loss as I am not a physician or a medical scientist. I'm going to tag @val64 as she is a lab scientist who may be able to explain the term or where to look up more information.

Loss of the PTEN gene is exceptionally common in all of the less dangerous forms of endometrial cancer, as categorized based on gene mutations, as can be seen in this Table:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8005218/table/cancers-13-01478-t002/
The four types of EC they're describing are listed across the top (POLE mutant, MMR deficient, "Non-Specific Molecular Profile" (NSMP), and p53 abnormal.) The percentage of each type that is defective for PTEN is shown in the "Top five recurrent gene mutations" row. For all three types, except the p53 abnormal group, at least 77% of all tumors are defective for PTEN.

So the fact that your tumor has PTEN loss is not something to worry about. It's a characteristic of the vast majority of lower grade ECs.

You didn't mention whether they tested your tumor for MLH1, MSH2, MSH6, and PMS2 or for POLE. In the US, all endometrial tumors are tested for MLH1, MSH2, MSH6, and PMS2, which is the test for MMR deficiency, although they may be waiting for the hysterectomy specimen to do that. As far as I know, it is still very uncommon in the US to test for POLE, although they really should. Apparently they do in Canada now.