Comparison of Estrogen and Progesterone Receptors in Endometrial Polyps and Normal Endometrium

Yıl 2019, Cilt: 50 Sayı: 1, 13 - 16, 14.03.2019

Şahin Yüksek Önder Sakin Bülent Kars Muzaffer Seyhan Çıkman Ali Doğukan Anğın Engin Ersin Şimşek

https://doi.org/10.16948/zktipb.392542

Öz

INTRODUCTION: The pathogenesis of endometrial polyps is still
unknown. Our aim in this research is to examine steroid receptors in
endometrial polyps.

METHODS: This study immunohistochemically stained estrogen and progesterone
receptors of both polyp and intact endometrium tissues of 28 patients who
underwent hysteroscopic polypectomy between February 2008 and December 2011 in
our hospital.

RESULTS: The coloring
scores were recorded as 3 positive for strong dyes, 2 positive for medium dyes
and 1 positive for weak dyes. In endometrial polyp gland estrogen receptors
were weak in 1 (3.6%) patient and strong in 17 (60.7%) patient. In the stroma,
5 (17.9%) patients were weak and 12 (52.8%) patients were strongly stained. The
endometrial tissues adjacent to the polyp 13 (46.4%) patients were weak and 5
(17.6%) patients were strong stained. In the stroma, 14 (50.0%) patients were
weak and 3 (10.7%) patients were strongly stained.

Progesterone receptors did not show weak staining on the endometrial polyp gland. Strong staining was observed in 27 patients (96.4%). There was no weak staining in stroma. Strong staining was observed in 25 patients (89.3%). The gland of the endometrial tissue adjacent to polyp; 4 (14.3%) patients weak, 18 (64.3%) moderate, and 6 (21.4%) patients were strong stained. In the stroma, 3 (10.7%) patients weak, 18 (64.3%) patients moderate and 7 (%25.0) patients were strongly stained.

CONCLUSION: Our findings support the importance
of steroid receptors on the development of endometrial polyps. Therapeutic
treatments for these receptors may be useful in preventing the development of
polyps, as well as in treatment and prevention of complaints. 

Anahtar Kelimeler

Polyps, estrogen receptor, progesterone receptor

Endometrial Polipler ile Normal Endometriumda Estrogen ve Progesteron Reseptörlerinin Karşılaştırılması

Öz

AMAÇ: Endometrial poliplerin patogenezi halen tam
olarak bilinmemektedir. Bu araştırmada amacımız endometrial poliplerdeki
steroid reseptörlerini incelemektir.

YÖNTEM: Bu
araştırmada Şubat 2008 ile Aralık 2011 tarihleri arasında hastanemizde histeroskopik polipektomi
yapılan 28 hastanın poliplerine ve sağlam endometrium dokularına ait östrojen
ve progesteron reseptörleri immunohistokimyasal olarak boyandı. Boyanma
skorları kuvvetli boyananlar için 3 pozitif, orta boyananlar için 2 pozitif ve
zayıf boyananlar için 1 pozitif olarak kaydedildi.

BULGULAR: Östrojen reseptörleri
endometriyal polip glandında 1 (%3.6) hastada zayıf, 17 (%60.7) hastada
kuvvetli boyandı.  Stromasında ise 5
(%17.9) hastada zayıf,  12 (%52.8)
hastada kuvvetli olarak boyandı. Polipin hemen yanındaki endometrial dokunun
glandında 13 (%46.4) hastada zayıf, 5 (%17.6) hastada kuvvetli boyandı.
Stromasında ise 14 (%50.0) hastada zayıf, 3 (%10.7) hastada kuvvetli boyandı.

Progesteron
reseptörleri için endometriyal polip glandında zayıf boyanma olmadı. Kuvvetli
boyanma 27 (%96.4) hastada görüldü. Stromasında da zayıf boyanma olmadı.
Kuvvetli boyanma 25 (%89.3) hastada görüldü. Endometriyal polipin hemen
yanındaki endometrium dokusunun glandında 4 (%14.3) hastada zayıf, 18 (%64.3)
hastada orta, 6 (%21.4) hastada kuvvetli boyandı. Stromasında ise 3 (%10.7)
hastada zayıf, 18 (%64.3) hastada orta, 7 (%25.0) hastada kuvvetli
boyandı. 

SONUÇ: Bulgularımız steroid
reseptörlerinin endometrial poliplerin gelişimi üzerine olan önemini destekler
niteliktedir. Bu reseptörlere yönelik geliştirilecek tedaviler hem poliplerin
gelişiminin önlenmesinde, hem tedavisinde, hem de sebep olduğu şikâyetlerin
engellenmesinde faydalı olabilecektir.

Anahtar Kelimeler

Polipler, östrojen reseptörü, progesteron reseptörü

Kaynakça

• 1-Tanos V, Berry KE, Seikkula J, Abi Raad E, Stavroulis A, Sleiman Z, et al. The management of polyps in female reproductive organs. Int J Surg. 2017 Jul;43:7-16. doi: 10.1016/j.ijsu.2017.05.012. Epub 2017 May 5.
• 2-Bel S, Billard C, Godet J, Viviani V, Akladios C, Host A, et al. Risk of malignancy on suspicion of polyps in menopausal women. Eur J Obstet Gynecol Reprod Biol. 2017 Sep;216:138-142. doi: 10.1016/j.ejogrb.2017.07.013. Epub 2017 Jul 15.
• 3-Al Chami A, Saridogan E. Endometrial Polyps and Subfertility. J Obstet Gynaecol India. 2017 Feb;67(1):9-14. doi: 10.1007/s13224-016-0929-4. Epub 2016 Aug 20.
• 4-Clark TJ, Stevenson H. Endometrial Polyps and Abnormal Uterine Bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated? Best Pract Res Clin Obstet Gynaecol. 2017 Apr;40:89-104. doi: 10.1016/j.bpobgyn.2016.09.005. Epub 2016 Oct 1.
• 5-Wong M, Crnobrnja B, Liberale V, Dharmarajah K, Widschwendter M, Jurkovic D. The natural history of endometrial polyps. Hum Reprod. 2017 Feb;32(2):340-345. doi: 10.1093/humrep/dew307. Epub 2016 Dec 18.
• 6-Sant'Ana de Almeida EC1, Nogueira AA, Candido dos Reis FJ, Zambelli Ramalho LN, Zucoloto S. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polypsand adjacent endometrium in postmenopausal women. Maturitas. 2004 Nov 15;49(3):229-33.
• 7-Zitao Liu, Kuokkanen S, Pal L. Steroid hormone receptor profile of premenopausal endometrial polyps. Reprod Sci. 2010 Apr;17(4):377-83. doi: 10.1177/1933719109356803.
• 8-Gul A, Ugur M, Iskender C, Zulfikaroglu E, Ozaksit G. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polypsand its relationship to clinical parameters. Arch Gynecol Obstet. 2010 Mar;281(3):479-83. doi: 10.1007/s00404-009-1142-9. Epub 2009 Jun 9.
• 9-Al-Azemi M, Labib NS, Motawy MM, Temmim L, Moussa MA, Omu AE. Prevalence of endometrial proliferation in pipelle biopsies in tamoxifen-treated postmenopausalwomen with breast cancer in Kuwait. Med Princ Pract. 2004 Jan-Feb;13(1):30-4.
• 10-Antunes A Jr, Vassallo J, Pinheiro A, Leão R, Neto AM, Costa-Paiva L. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps: A comparison between benign and malignant polyps in postmenopausal patients. Oncol Lett. 2014 Jun;7(6):1944-1950. Epub 2014 Mar 28.
• 11-Mittal K, Schwartz L, Goswami S, Demopoulos R. Estrogen and progesterone receptor expression in endometrial polyps. Int J Gynecol Pathol. 1996 Oct;15(4):345-8.
• 12-Belisário MS, Vassallo J, Andrade LA, Alvarenga M, Pinto GA, Monteiro IM. The expression of the hormone receptors in the endometrium and endometrial polyps in postmenopausal women and its relationship to body mass index. Maturitas. 2006 Jan 10;53(1):114-8.
• 13-Lopes RG, Baracat EC, de Albuquerque Neto LC, Ramos JF, Yatabe S, Depesr DB, et al. Analysis of estrogen- and progesterone-receptor expression in endometrial polyps. J Minim Invasive Gynecol. 2007 May-Jun;14(3):300-3.
• 14-Van Dijk MM, van Hanegem N, de Lange ME, Timmermans A. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy? J Minim Invasive Gynecol. 2015 Nov-Dec;22(7):1153-62. doi: 10.1016/j.jmig.2015.06.016. Epub 2015 Jul 4.
• 15-Iatrakis G, Zervoudis S, Antoniou E, Tsionis C, Pavlou A, Kourounis G, et al. Is dosage of hormone replacement therapy related with endometrial polyp formation? Eur J Gynaecol Oncol. 2006;27(4):393-4.
• 16-Dominick S, Hickey M, Chin J, Su HI. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen. Cochrane Database Syst Rev. 2015 Dec 9;(12):CD007245. doi: 10.1002/14651858.CD007245.pub3.
• 17-Yang JH, Chen CD, Chen SU, Yang YS, Chen MJ. Factors Influencing the Recurrence Potential of Benign Endometrial Polyps after Hysteroscopic Polypectomy. PLoS One. 2015 Dec 11;10(12):e0144857. doi: 10.1371/journal.pone.0144857. eCollection 2015.