The Nuclear β-Catenin Expression as a Prognostic Indicator and Its Clinicopathologic Correlates in Endometrial Adenocarcinoma: A Retrospective Study from Albayda Medical Center, Libya

• Jameelah Sulayman

  Pathology Department, Faculty of Medicine, Omar Al-Mukhtar University, Al-Bayda, Libya

  Author

• Ahmed Elsayed

  Pathology Department, Director of Medical Program, Apollonia University, Benghazi, Libya

  Author

• Bushra Abogharsa

  Pathology Department, Faculty of Medicine, Omar Al-Mukhtar University, Al-Bayda, Libya

  Author

• Ahmad Mohammed

  Pathology Department, Tanta Center, Egypt

  Author

  Endometrial carcinoma is the most frequent gynecological malignancy in developed countries; however, despite its rising incidence, there remains a critical deficiency in validated biomarkers for early-stage detection. The Wnt/β-catenin signaling axis is frequently dysregulated, typically as a consequence of oncogenic CTNNB1 mutations, and plays a key role in tumor development by facilitating nuclear β-catenin accumulation, an indicator of more aggressive disease. This study aimed to explore the potential of nuclear β-catenin expression as a prognostic biomarker by retrospectively analyzing 30 cases of endometrioid adenocarcinoma diagnosed between 2014 and 2022 at Albayda Medical Center in Libya. Immunohistochemistry was used to score nuclear β-catenin expression on a 0–3 scale, with a score of ≥2 considered high. Associations with clinicopathological variables, including age, marital status, menopausal status, tumor grade, stage, metastasis, and family history, were evaluated. The results revealed that high nuclear β-catenin expression occurred in 30% (9/30) of tumors and significantly correlated with younger age (<56 years; 54.5% vs 15.8%; p = 0.026), premenopausal status (75% vs 9.1% perimenopausal and 33.3% postmenopausal; p = 0.044), single marital status (53.8% vs 11.8% married; p = 0.013), positive family history (50% vs 7.1%; p = 0.011), high tumor grade (80% Grade III vs 14.3% Grade I; p = 0.026), advanced stage (80% Stage II and IV vs 10.5% Stage I; p = 0.015), and metastasis (83.3% vs 16.7% non-metastatic; p = 0.001). These findings suggest that nuclear β-catenin accumulation serves as a strong marker of aggressive disease, linking hormonal exposure, reproductive history, and potential hereditary cancer risk into a unified molecular framework. Despite limitations of a small sample size and retrospective design, this study underscores the clinical utility of β-catenin immunohistochemistry as a cost-effective tool for improved risk assessment, early identification of high-risk patients, and personalized treatment planning.

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