Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps: A comparison between benign and malignant polyps in postmenopausal patients.

Armando Antunes,Lucia Costa-Paiva,Anderson Pinheiro,Aarão Mendes Pinto Neto,Rogério Leão,José Vassallo

doi:10.3892/ol.2014.2004

Armando Antunes, Lucia Costa-Paiva + Show 4 more

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https://doi.org/10.3892/ol.2014.2004

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Journal: Oncology letters	Publication Date: Mar 28, 2014
Citations: 12	License type: CC BY 3.0

Affiliation: Universidade Estadual de Campinas

Abstract

The aim of the present study was to evaluate estrogen receptor (ER) and progesterone receptor (PR) expression in the glandular epithelium and stroma of benign and malignant endometrial polyps of postmenopausal patients. A total of 1,050 females underwent surgical hysteroscopy at the Professor Dr José Aristodemo Pinotti Women’s Hospital, Center for Integral Attention to Women’s Health of the State University of Campinas, between January 1998 and December 2008. Of the total number, 390 postmenopausal females with endometrial polyps were included in the study. Polypoid lesions were histologically classified as benign lesions (endometrial polyps and polyps with non-atypical simple hyperplasia or non-atypical complex hyperplasia) and premalignant and malignant lesions (polyps with atypical simple hyperplasia or atypical complex hyperplasia and carcinomatous polyps). ER and PR expression was evaluated by immunohistochemistry according to cell staining, intensity of nuclear staining and final score. The final score for receptor expression was compared between the benign and premalignant/malignant polyps. The prevalence of malignancy in endometrial polyps was 7.1% and was associated with postmenopausal bleeding. Only the final score for ER expression in the stroma of endometrial polyps was higher in the benign group than in the premalignant/malignant group, and this difference was significant. However, no difference was identified in PR expression. In addition, the risk of malignancy in endometrial polyps was significantly higher when the expression of ER and PR was negative in the stromal component of the polyp (P<0.01). The malignancy of endometrial polyps was also associated with a low expression of stromal ER, however, PR expression did not show any association with the risk of malignancy.

Highlights

IntroductionThe prevalence of polyps ranges between 7.8 and 34.9%, depending on the method used for diagnosis and the study population [2]
Endometrial polyps are localized overgrowths of the endometrium, with histological features composed of the irregular proliferation of glands and stroma, containing thick‐walled blood vessels and lined by pseudostratified or flat epithelium [1].The prevalence of polyps ranges between 7.8 and 34.9%, depending on the method used for diagnosis and the study population [2]
The premalignant lesions consisted of five polyps with atypical simple hyperplasia (1.28%) and three polyps with atypical complex hyperplasia (0.76%)

Summary

Introduction

The prevalence of polyps ranges between 7.8 and 34.9%, depending on the method used for diagnosis and the study population [2]. Prevalence has been found to increase with age and is higher in postmenopausal patients compared with premenopausal patients [3]. The malignancy rate associated with endometrial polyps is low, and in a recent meta‐analysis on the oncogenic potential of polyps, it was observed that the malignancy rate of endometrial polyps ranged between 0.8 and 8% in the different studies analyzed [4]. A higher occurrence of premalignant and malignant polyps was observed in postmenopausal females aged over 60 years with vaginal bleeding [5]. Other studies have shown an association between malignancy and certain risk factors, including obesity, arterial hypertension, diabetes mellitus and tamoxifen use [4,6]

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