YAŞAR ÜNLÜ, İlyas ÖZARDALI, Rızvan T. ORHA, Kemal BEHZATOĞLU

Endometrial hiperplazi ve adenokarsinomlarda östrojen reseptörlerinin durumu

Amaç: Bu çalışmada, endometrial hiperplazi ve endometrial adenokarsinom teşhisi almış vakalarda progesteron reseptörleri (PR) ile ilgili bulguların karşılaştırılması amaçlanmıştır. Yöntem: Basit tipte endometrial hiperplazi tanısı almış 15 vaka ile iyi diferansiye (grade I) endometrial adenokarsinom tanısı almış 15 vakaya peroksidaz-antiperoksidaz metodu ile parafin kesitlerine spesifik fare monoklonal PR antikorları uygulandı ve dokulardaki progesteron reseptörleri araştırıldı. Bulgular: PR’lerinin spesifik boyanması sadece çekirdekte sınırlı idi, sitoplazmada spesifik boyanma tesbit edilmedi. Endometrial hiperplazi vakalarının tamamında epitelial ve stromal hücrelerin çekirdeklerinde PR pozitifliği mevcut iken, endometrial adenokarsinom vakalarında bu oran epitel hücrelerinde % 73.3, stroma hücrelerinde ise % 33.3 olarak tespit edildi. Sonuç: Endometrial hiperplazi vakaları endometrial adenokarsinom vakalarından daha yüksek oran ve konsantrasyonda PR içermektedir.

Estrogen receptors in hyperplastic and carcinomatous endometria

Objective: This study was aimed to compare progesterone receptors (PR) in endometrial hyperplasia and in endometrial adenocarcinoma was aimed. Methods: 15 cases with simple endometrial hyperplasia and 15 cases with grade I endometrial adenocarcinoma were evaluated. Specific mouse monoclonal antibody against progesterone receptors was used with peroxidase-antiperoxidase technique to localize PR in paraffin-embedded sections. Results: Specific staining for PR was always limited to nuclei; no specific cytoplasmic staining was observed. PR was positive in the nuclei of epithelial cells and in the nuclei of stromal cells of all the patients with endometrial hyperplasia. This ratio was 73.3% in the nuclei of epithelial cells and 33.3% in the nuclei of stromal cells of the endometrial adenocarcinoma cases. Conclusion: Endometrial hyperplasia cases contain more progesterone receptors than endometrial adenocarcinoma cases.

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1. Fox H. Haines and Taylor’s obstetrical and gynecological pathology. Vol I, 3rd ed. New York: Churchill-Livingstone; 1987.
2. Kurmann RJ, Kumaski PF. The behavior of endometrial hyperplasia. Cancer 1985;56:403-12.
3. Novak Edmund R, Woodruf JD. Novak's gynecologic and obstetric pathology. 8th ed. Philadelphia: WB Saunders Comp; 1979.
4. Rosai J. Ackerman's surgical pathology. Vol II, 7th ed. Washington: CV Mosby Comp; 1989.
5. Sternberg SS. Diagnostic surgical pathology. Vol II, 2nd ed. New York: Raven Press; 1994.
6. Boman K, Isomaa V. Immunocytochemical study of the human 17 β-hydroxysteroid dehidrogenase and steroid receptors in endometrial adenocarcinoma. Cancer 1992;70:1551-5.
7. Kauppila A, Vihko R. Cytosol estrogen and progestin receptors in endometrial carcinoma of patients treated with surgery, radiotherapy and progestin. Cancer 1982;50:2157-62.
8. Carcangiu ML, Chambers JT. Immunocytochemical evalution of estrogen and progesterone receptor content in 183 patients with endometrial carcinoma. Am J Clin Pathol 1990;94:247-54.
9. Creasman WT, McCarty KS, Soper JT. Endometrial adenocarcinoma estrogen receptor content: Association of clinicopathologic features with immunohistochemical analysis compared with standard biochemical methods. Am J Obstet Gynecol 1987;157:924- 31.
10. Segreti EM, Novotny DB. Endometrial cancer: Histologic correlates of immunohistochemical localization of progesterone receptor and estrogen receptor. Obstet Gynecol 1989;73:780.
11. Coffer A, King RJB. Immunoradiometric studies with monoclonal antibody against a component related to human estrogen receptor. Cancer Res 1985;45:3694-8.
12. Novotny B, McCarty KS. Immunohistochemical analyses of estrogen receptor in endometrial adenocarcinoma using a monoclonal antibody. Cancer Res 1986;46:5419-25.
13. Pertschuk LP, Beddoe AM. Immunohistochemical assay of estrogen receptors in endometrial carcinoma with monoclonal antibodies. Cancer 1986;57:1000-4.
14. Press MF, King WJ. Immunohistochemical assessment of estrogen receptor distribution in the human endometrium during the menstrual cycle. Lab Invest 1984;51:495-503.
15. Applanat MP, Milgrom E. Immunocytochemical study with monoclonal antibodies to progesterone receptor in human breast tumors. Cancer Res 1987;47:2652-61.
16. Hort O, Kwan PWL, Delellis A. Immunohistochemistry of estrogen receptor protein in paraffin sections. Am J Clin Pathol 1988;90:559-63.
17. McCarty KS, Miller LS. Estrogen receptor analyses correlation of biochemical and immunohistochemical methods using monoclonal antireceptor antibodies. Arc Pathol Lab Med 1985;109:716-21.
18. Bergeron C, Ferenczy A. Immunocytochemical study of progesterone receptors in the human endometrium during the menstrual cycle. Lab Invest 1988:59:862-9.
19. Evans LH, Marthin JD. Estrogen receptor concentration in normal and pathological human uterine tissues. J Clin Endocrinol Metab 1974;38:23-32.
20. Arısan K. Kadın Hastalıkları (Jinekoloji). stanbul: 1983.
21. plikçi A. Kadın genital sistem ve meme hastalıkları patolojisi. stanbul: Ü Yayınları; 1990.
22. Sözen U, Maral , Balık E, Bayol Ü, Ortaç R. Endometrial hiperplazide siklik progesteron tedavisi ve histopatolojik sonuçların deerlendirilmesi. Jinekolojik Obstetrik 1993;3:232-8.
23. Haukamaa M, Karjalaimen O. Invitro binding of progesterone by hyperplastic, atrophic and carcinomatous endometrium. Am J Obstet Gynecol 1971;111:205-10.
24. Coffer A, King RJB. monoclonal antibodies against a component related to soluble estrogen receptor. Cancer Res 1985;45:3686- 93.
25. Ehrlich CE, Young PCM. Cytoplasmic progesterone and estradiol receptors in normal, hyperplastic and carcinomatous endometria: Therapeutic implications. Am J Obstet Gynecol 1981;141:539-46.
26. Papadimitriou CS, Athanasiadou S. Immunohistochemical detection of estrogen receptors on paraffin section of normal, hyperplastic and carcinomatous endometrium. Oncology 1992;49:196-202.
27. Creasman WT. Prognostic significance of hormone receptors in endometrial cancer. Cancer 1993;71:1467-71.
28. Creasman WT, Soper JT. Influence of cytoplasmic steroid receptor content on prognosis of early stage endometrial carcinoma. Am J Obstet Gynecol 1985;151:922-32.
29. Ehrlich CE, Young PCM. Steroid receptors and clinical outcome in patients with adenocarcinoma of the endometrium. Am J Obstet Gynecol 1988;158:796-807.
30. Liao BS, Twiggs LB. Cytoplasmic estrogen and progesterone receptors as prognostic parameters in primer endometrial carcinoma. Obstet Gynecol 1986;67:463-7.
31. Mortel M, Zaina R. Heterogeneity and progesterone receptor with monoclonal antibodies to the human progestin receptor. Endocrinology 1988;122:1165-75.