![]() ![]() With increased refinement of immunohistochemistry, we, and others, observed other abnormal p53 expression patterns that correlate with the presence of a TP53 mutation. This is in the form of diffuse strong nuclear positivity involving at least 80% of the tumor cells but usually almost 100%. It has long been recognized that nonsynonymous TP53 missense mutations result in nuclear accumulation of p53 protein that can be detected as overexpression by immunohistochemistry. These include laboratory methods to optimize staining, a description of the different patterns of staining, advice regarding the interpretation, and reporting of p53 staining and practical uses of p53 staining in endometrial carcinomas. The aim of this review is to provide practical advice to pathologists regarding various aspects of p53 immunohistochemical staining. Hence, p53 immunohistochemistry is very commonly utilized on endometrial carcinoma samples. As most pathologists do not have access to TP53 sequencing, they use p53 immunohistochemistry, which is quick, easy to perform, and inexpensive, as a surrogate for TP53 mutational analysis. The value of p53 in these scenarios is discussed in several other papers in this issue. The TP53 mutation status may be used clinically in different ways such as aiding in the distinction between serous and endometrioid histotype 3, 4, predicting outcome within a given histotype 1, 5 or predicting outcome across several histotypes 2. ![]() The mutational status of TP53 is the single most important molecular factor, which predicts prognosis in endometrial carcinomas, with the presence of a TP53 mutation being associated with an unfavorable outcome 1, 2. ![]()
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