DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151184

A study of expression of estrogen and progesterone receptor, in atrophic, hyperplastic and malignant endometrial lesions, with emphasis on relationship with prognostic parameters

Pasam Ramana Kumari, Inuganti Venkata Renuka, Murari Apuroopa, Padmavathi Devi Chaganti

Abstract


Background: Aims of current study were to study the expression of estrogen receptor (ER) and progesterone receptor (PR) in atrophic, hyperplastic and malignant endometrial tissue, using immunohistochemical markers.

Methods: The study includes 100 cases of endometrial tissues (25 cases each of atrophic and hyperplastic endometria and 50 cases of endometrial carcinomas).

Results: In atrophic endometrial, 20 cases were ER and PR rich. 5 cases showed complete loss of hormone receptors (4 were type I and 1 type II). All the 25 cases of hyperplasias were ER and PR positive with varying H-score. The analysis of the hormone receptors in endometrial carcinomas, indicated that ER in 34 cases (68%) and of the PR in 38 cases (76%) were positive.

Conclusions: Majority of the asymptomatic postmenopausal atrophic and hyperplastic endometria, expressed ER and PR. The value of the statistical significance was equal for atrophic vs. carcinomas and also hyperplastic vs. carcinomas. Positive ER PR expression was significantly associated with grade I-II and stage IB tumours. The correlation of immunohistochemical findings with histologic grade and clinical stage could help in predicting biologic behaviour and planning treatment in patients who are diagnosed as having these tumors.

 


Keywords


Estrogen receptor, Progesterone receptor, Endometrial carcinoma, Hyperplasia and atrophic endometria

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References


Creasman WT, Endometrial cancer incidence, prognostic factors, diagnosis and treatment. Semin Oncol. 1997;24:S1-140-S1-50.

Sherman ME. Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol. 2000;13:295-308.

Ochler MK, Rees MC, Bicknell R. Steroids and the endometrium. Curr Med Chen. 2000;7:543-60.

Esivridis A, Giatromanolaki. Proliferative activity in postmenopausal endometrium: the lurking potential for giving rise to an endometrial adenocarcinoma. J Clin Pathol. 2004;57:840-44.

Ishibashi H, Suzuki T, Suzuki S, Moriya T, Kaneko C, Takizawa T, et al. Sex steroid hormone receptors in human thymoma. J Clin Endocrin Metab. 2003;88(5):2309-17.

Kuiper GG, Carlsson B, Grandien K, Enmark E, Haggblad J, Nilsson S, et al. Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology. 1997;138:863-70.

Buckely CH, Fox H. Biopsy Pathology of the endometrium. In: Buckely CH, Fox H, eds. A Book. 2nd ed. London: Arnold; 2002.

Archer DF, Mdntyre-Seltman K, Nilborn WW Jr, Dowling EA, Cone F, Creasy GW, et al. Endometrial morphology in asymptomatic postmenopausal women. Am J Obstet Gynecol. 1991;165:317-22.

Korhonem MO, Symans JP, Hyde BM, Rowan JP, Wilborn WH. Histologic classification and pathologic findings for endometrial biopsy specimens obtained from 2968 perimenopausal and post-menopausal women undergoing screening for continuous hormone replacement therapy (CHART 2 study). Am J Obstet Gynecol. 1997;176:377-80.

Naci I, Borri P, Scarselli G, Chieffi O, Bucciantini S, Biagiotti R, et al. Morphological and functional aspects of the endometrium of asymptomatic postmenopausal women: does the endometrial age? Hum Reprod. 1996;11:2246-50.

World Health Organisation. Classification of tumors. Pathology and Genetics of Tumors of Breast and Female Genital Organ. Lyon: IARC Press; 2003.

Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10-7.

Prat J. Prognostic parameters of endometrial carcinoma. Hum Pathol. 2004;35(6):649-62.

Sivridis E, Fox H, Buckley CH. Endometrial carcinoma: two or three entities. Int J Gynecol Cancer. 1998;8:183-8.

Mcbride JM. Postmenopausal cystic hyperplasia and endometrial carcinoma. J Obstet Gynaecol Br Emp. 1959;66:288-96.

Baak JP, Wisse-Brekelmans EC, Fleege JC, van der Putten HW, Bezemer PD. Assessment of the risk on endometrial cancer in hyperplasia by means of morphological and morphometrical features. Pathol Res Pract. 1992;188:156-9.

Kurman RJ, Kaminski PF, Norris HJ. The behaviour of endometrial hyperplasia. A longterm study of untreated hyperplasia in 170 patients. Cancer. 1995;56:403-12.

Nyholm HC, Nielson AL, Lyndru PT, Norup P, Thorpe SM. Biochemical and immunohistochemical estrogen and progesterone receptors in endometrial hyperplasia and endometrial carcinoma. Am J Obstet Gynaecol. 1992;167(5):1334-42.

Chirtine Bergeron, Alex Ferenczy, David O. Toft, Gopalan Shyamala. Immunocytochemical study of progesterone receptors in hyperplastic and neoplastic endometrial tissues. Cancer Res. 1988;48:6132-6.

Hoskins WJ, Perez CA, Young RC. The endometrial carcinoma. In: Hoskins WJ, Perez CA, Young RC, eds. Principles and Practice of Gynaecologic Oncology. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2000: 1005-1007.

Kim JW, Kim SH, Kim YT, Kim DK. Clinicopathologic and biological parameters predicting the prognosis in endometrial cancer. Yonsei Med J. 2002;43(6)769-78.

Stefansson IM, Salvesen HB, Immervol IH, Akslen LA. Prognostic impact of histological grade and vascular invasion compare with tumor cell proliferation in endometrial carcinoma of endometrioid type. Histopathology. 2004;44(5):475-9.

Suthipintawong C, Wejavanayong C, Vipupinyo C. Prognostic significance of ER, PR, Ki67, CerbB2 and p53 in endometrial carcinoma. J Med Assoc Thai. 2008;91(12):1779-84.

Shakni N, Kuhn C, Kunze S, Schulze S, Mayr D, Dia D, et al. Prognostic significance of estrogen receptor alpha and beta, progesterone receptor A and B in endometrial carcinoma. Eur J Cancer. 2007;43(16):2434-44.

Stenchever MA, Mishell D, Herbst AL, Droegemueller W. Comprehensive gynecology. In: Stenchever MA, Mishell D, Herbst AL, Droegemueller W, eds. A Book. 2nd ed. US: Elsevier Health Sciences; 2001.

Nyholm HC. Endometrial cancer and steroid hormone receptors. Ugeskrlaeger. 1990;152(9):593-7.

Kounelis S, Kapranos N, Kouri E, Coppola D, Papadaki H, Jones MW. Immunohistochemical profile of endometrial adenocarcinoma: a study of 61 cases and review of literature. Mod Pathol. 2000;13(4):379-88.

Halperm R, Zehavi S, Habler L, Hadas E, Bukovsky I. Comparative immunohistochemical study of endometrioid and serous papillary carcinoma of endometrium. Eur J Gynaecol Oncol. 2001;22(2):122-6.

Naim Shabani, Ioannis Mylonas, Udo Jeschke, Agim Thagi. Expression of estrogen receptors alpha and beta and progesterone receptors A and B inhuman mucinous carcinoma of endometrium. Anticancer Res. 2007;27:2027-34.