Table 2

Features of endometrial precancers

Prediction	Evidence
Precancers differ from normal tissue	Monoclonal precancers^12,^21,^23,²⁵ arise from a polyclonal normal field²⁴
	Mutations are acquired in precancers^23,^38,^49–⁵³

Precancers share some, but not all, features of cancer	Precancer–cancer lineage hierarchy²⁶
	May share PTEN,^37,^38,⁵⁵ K-ras,^52–^54,⁵⁶ MLH1^51,⁵⁷ changes
	Both are monoclonal^21,^23,^25,^58,⁵⁹

Precancers increase risk for carcinoma	Increased concurrent cancer rate³⁰
	Increased future cancer rate^31,³²

Precancers can be diagnosed	Morphometric standard^21,^22,^29,⁵⁰
	Endometrial intraepithelial neoplasia = precancers (table 1)

Hormonal and genetic risks are linked	Hormonal modulation of the PTEN gene,⁴⁵ frequently inactivated in premalignant disease^37,^38,^41,⁵³

Precancers can be induced by manipulating genetic and/or hormonal variables	100% of PTEN mutant heterozygote mice get endometrial “hyperplasia” and 21% of these evolve to carcinoma⁶⁰

Diagnosis of premalignant endometrial disease

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