{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:15:04Z","timestamp":1789578904677,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Pathology, UTSW"},{"name":"University of Texas Southwestern Medical Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Despite advancements in treatment options, endometrial cancer remains a significant threat to women, underscoring the importance of early detection of atypical hyperplasia\/endometrioid intraepithelial neoplasia (AH\/EIN), the widely accepted histological precursor to endometrial carcinoma. Even with refinements in morphological criteria for the diagnosis of AH\/EIN, accurate diagnosis remains challenging for pathologists, particularly in cases with secretory changes. Morphological alterations resulting from secretory-related changes further complicate the application of diagnostic criteria, emphasizing the need for reliable biomarkers. Previous studies have demonstrated that a panel consisting of three immunohistochemical markers, PAX2, PTEN, and \u03b2-catenin, can be effectively utilized for the identification of AH\/EIN in various non-secretory scenarios. Methods: In this study, a total of 69 AH\/EIN within secretory endometrium were analyzed using this panel. Benign interval endometrium (n = 57) and secretory phase endometrium (n = 71) were also analyzed for PAX2, PTEN, and \u03b2-catenin expression as controls. Results: The 3-marker panel successfully identified 93% of secretory AH\/EIN, comparable to its performance in identifying non-secretory bona fide AH\/EIN (92.8%) and AH\/EIN within endometrial polyps (92.4%). Of note, \u03b2-catenin expression in benign interval endometrium commonly displayed weak nuclear staining (67%), which could pose a diagnostic pitfall when using the 3-marker panel. Overall, the results demonstrate the diagnostic utility of the 3-marker panel in clinical practice in identifying AH\/EIN within challenging secretory phase endometrium cases. Conclusions: Combined with previous research highlighting its effectiveness in other challenging contexts\u2014such as AH\/EIN in polyps, small-sized EIN (subdiagnostic EIN), and progestin-treated EIN\u2014this study provides strong evidence supporting the panel\u2019s broad applicability in resolving major diagnostic challenges related to the precise diagnosis of AH\/EIN.<\/jats:p>","DOI":"10.3390\/cancers17091495","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T05:17:12Z","timestamp":1745903832000},"page":"1495","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Expression Characteristics of 3-Marker Panel (PAX2, PTEN, and \u03b2-Catenin) in Benign Interval and Secretory Endometrium and Secretory Endometrial Precancer"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-4757","authenticated-orcid":false,"given":"Shuang","family":"Niu","sequence":"first","affiliation":[{"name":"Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA"},{"name":"Department of Pathology, Parkland Hospital, Dallas, TX 75235, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Molberg","sequence":"additional","affiliation":[{"name":"Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA"},{"name":"Department of Pathology, Parkland Hospital, Dallas, TX 75235, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Chen","sequence":"additional","affiliation":[{"name":"Coppell High School, Coppell, TX 75019, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Conrad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX 75390, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA"},{"name":"Department of Pathology, Parkland Hospital, Dallas, TX 75235, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-0237","authenticated-orcid":false,"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390, USA"},{"name":"Department of Pathology, Parkland Hospital, Dallas, TX 75235, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. 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