title: Paired boxed gene 1 expression: A single potential biomarker for differentiating endometrial lesions associated with favorable outcomes in patients with endometrial carcinoma.
abstract: OBJECTIVE
  Paired boxed gene 1 (PAX1) has previously been reported to be a methylation-silenced gene in cases of cervical and ovarian cancers. We evaluated the expression of PAX1 in normal endometrium, endometrial hyperplasia and endometrial carcinoma (EC), and investigated the prognostic value of PAX1 expression in patients with EC.
  
  
  METHODS
  We conducted a hospital-based retrospective review of PAX1 distribution immunohistochemically in 201 samples of endometrium from biopsy or hysterectomy. PAX1 immunoreactivity was classified into low and high score groups based upon the extent and intensity of staining.
  
  
  RESULTS
  There was intense intranuclear staining for PAX1 in premalignant endometrial lesions. A high PAX1 score was observed in a high percentage of samples of normal endometrium (93.3%), in endometrial hyperplasia without atypia (97.2%) and in endometrial atypical hyperplasia (87.5%), but this level was found in only one-third of the EC samples (30.1%). The PAX1 protein score was significantly higher in samples of premalignant endometrial lesions compared with those of EC (P < 0.001). Importantly, a higher PAX1 score in EC cases was correlated with good overall survival, with a hazard ratio of 0.22 for death (95% confidence interval, 0.05-0.96).
  
  
  CONCLUSIONS
  PAX1 protein expression is a potential histopathology biomarker for the differential diagnosis of malignant and premalignant endometrial lesions. PAX1 is also a potential prognostic marker in cases of EC.
authors.affiliation: Division of Obstetrics and Gynecology, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan.|Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Department of Medical Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Liu
authors.affiliation: Department of Medical Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Department of Life Sciences, Department and Graduate Institute of Biochemistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hung-Cheng
authors.initials: HC
authors.lastname: Lai
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Chou
authors.affiliation: Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Rui-Lan
authors.initials: RL
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Yu
authors.affiliation: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chi-Pin
authors.initials: CP
authors.lastname: Lin
authors.affiliation: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-Chiuan
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kai-Jo
authors.initials: KJ
authors.lastname: Chiang
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Department of Medical Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yu-Chi
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. chaotai.kuang@msa.hinet.net.
authors.forename: Tai-Kuang
authors.initials: TK
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D003937:Diagnosis, Differential; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D004717:Endometrium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D051761:Paired Box Transcription Factors / Q000378:metabolism*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D051761:Paired Box Transcription Factors; C070835:PAX1 transcription factor
keywords: PAX1; atypical endometrial hyperplasia; endometrial carcinoma; endometrial hyperplasia; immunohistochemistry