Abstract
Anti-Müllerian hormone (AMH) is a commonly known factor secreted by Sertoli cells, responsible for regression of the Müllerian ducts in male fetuses. AMH has also other functions in humans. In vivo and in vitro studies have shown that AMH inhibits cell cycle and induces apoptosis in cancers with AMH receptors. The aim of the study was to assess whether the tissue of pre-cancerous states of endometrium (PCS) and various histopathologic types of endometrial cancer (EC) exhibit the presence of AMH. We aimed to investigate whether the potential presence of the protein concerns menopausal women or those regularly menstruating, and whether is related to cancers with a good or a bad prognosis, as well as what other factors may influence AMH expression. The undertaken analysis was carried out on tissues retrieved from 232 women who underwent surgical treatment for PCS and EC. Tissues were prepared for immunohistochemical assessment with the use of a tissue microarrays method. AMH expression was confirmed in 23 patients with well differentiated endometrioid adenocarcinoma (G1), moderately differentiated endometrioid adenocarcinoma (G2), clear cell carcinoma (CCA) and nonatypical hyperplasia. AMH was not found in EC tissues in regularly menstruating women. An appropriately long mean period of breastfeeding in line with a prolonged period of hormonal activity had a positive effect on AMH expression. Our results may suggest that AMH is a factor which protects the organism against cancer, and should be further investigated as a potential prognosis marker and a therapeutic agent.
Highlights
Anti-Müllerian hormone (AMH) known as Müllerian-Inhibiting Substance, is a well-studied regulatory molecule in reproductive functioning, especially in sexual differentiation during early embryonic development [1]
The normal levels of serum AMH in women between puberty and menopause amount to 1.4–5 ng/mL [15,59], and it decreases to undetectable values [60]
A positive correlation was found between the AMH level and gross aggregate tumor mass determined by pathology, as well as between the AMH level and radiographic aggregate tumor mass [52]
Summary
Anti-Müllerian hormone (AMH) known as Müllerian-Inhibiting Substance, is a well-studied regulatory molecule in reproductive functioning, especially in sexual differentiation during early embryonic development [1]. AMH is secreted by Sertoli cells of the male embryo testes as early as during the 8th–10th week of gestation [9,10,11]. This hormone is responsible for regression of the Müllerian ducts in the processes of apoptosis, auto-phagocytosis, cell migration and remodeling [12,13,14,15,16]. Around the 36th week of gestation, granulosa cells of small growing ovarian follicles undergoing initial recruitment begin to secrete AMH [10,18,19]. Since the serum AMH level reflects the quantity and quality of the ovarian follicular pool, it is a dependable indicator of response to in vitro fertilization protocols in assessing the pregnancy success [17,27,28,29,30]
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