Abstract
Background70–80% of sporadic endometrial carcinomas are defined as endometrioid carcinoma (EC). Early-stage, well differentiated endometrial carcinomas usually retain expression of estrogen and progesterone receptors (ER and PR, respectively), as advanced stage, poorly differentiated tumors often lack one or both of these receptors. Well-described EC prognosis includes tumor characteristics, such as depth of myometrial invasion. Therefore, in the current study, we evaluated the expression profile of ER and PR isoforms, including ER-α, PR-A and PR–B, in correlation to EC tumor histological depth.MethodsUsing immunohistochemistry and image analysis software, the expression of ER-α, PR-A, PR–B and Ki67 was assessed in endometrial stroma and epithelial glands of superficial, deep and extra-tumoral sections of 15 paraffin embedded EC specimens, and compared to 5 biopsies of non-malignant endometrium.ResultsExpression of PR-A and ER-α was found to be lower in EC compared to nonmalignant tissue, as the stromal expression was dramatically reduced compared to epithelial cells. Expression ratios of both receptors were significantly high in superficial and deep portions of EC; in non-tumoral portion of EC were close to the ratios of nonmalignant endometrium. PR-B expression was low in epithelial glands of EC superficial and deep portions, and high in the extra-tumoral region. Elevated PR-B expression was found in stroma of EC, as well.ConclusionsThe ratio of ER-α and PR-A expression in the epithelial glands and the stroma of EC biopsies may serve as an additional parameter in the histological evaluation of EC tumor.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1155060506119016
Highlights
70–80% of sporadic endometrial carcinomas are distinguished as type I carcinomas, which is the most common malignancy in female reproductive tract and defined as endometrioid carcinoma (EC)
Estrogen receptor (ER)-α, Progesterone receptor (PR)-A and Ki67 scoring Scoring levels of ER-α, PR-A and Ki67, shown in Table 1 and in Table 2, reflects the common assessment of markers expression, which includes counting of stained epithelial cells detected in 10 high power fields (X40)
In the current study, we have showed the importance of referring to steroid receptors profile in the stroma as well as the epithelial cells
Summary
70–80% of sporadic endometrial carcinomas are distinguished as type I carcinomas, which is the most common malignancy in female reproductive tract and defined as EC. The glandular epithelium from which the cancer arises is hormone responsive, expressing both PRs and ERs [1]. EC often develops from endometrial hyperplasia, which. ER-β, encoded by separate genes, ESR1 and ESR2 respectively, binding the same estrogen response elements (EREs) and regulate similar sets of genes [7]. ER-α and ER-β has a distinct pattern of expression in the tissues [8], which varies during cellular proliferation and differentiation [9]. ER-α is required for the basic development of estrogen sensitive tissues and ER-β is required for organization and adhesion of epithelial cells and for differentiated tissue morphology and its functional maturation [10]
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