Morphological features and activity of estrogen receptors of endometrium and foci of adenomyosis in postmenopausal patients

Abstract

Aim . The article is devoted to the research of morphological features and activity of estrogen receptors of endometrium and foci of adenomyosis in postmenopausal patients. Materials and methods. 30 cases of adenomyosis were investigated in the presence of the hyperplastic processes in the endometrium (endometrial adenocarcinoma of the uterine body and endometrial hyperplasia) and without it (age changes) in patients aged 51-73 years. We conducted immunohistochemical research and hematoxylin and eosin stain. IHC blocks were produced by the method of Tissue Microarray. The expression of estrogen markers was evaluated according to point system of general staining method for ER-status determining. Results. Morphological structure of eu- and ectopic endometrium was studied in the work in detail, according to comorbidity. Moderately differentiated adenocarcinoma (G2) was diagnosed in 4 cases out of 10 in the group with the endometrial adenocarcinoma, and in 6 cases - level 2 of the nuclear atypia. It was revealed that morphological picture of adenomyosis in the presence of hyperplastic processes in the endometrium is characterized by the predominance of glandular component over stromal one in the ectopic endometrium. Significant differences between all the groups of the studied women during the estimation of the levels of the estrogen activity of the components of the eutopical endometrium were not revealed, with the exception of endometrial adenocarcinoma. Comparative analysis of our results with data of the other researchers was conducted. Conclusion. It was established that the foci of adenomyosis retain their activity, that is morphologically manifested as the foci of proliferation and secretion. The level of ER expression of eutopical endometrium dominates over the endometrium of adenomyosis foci in the presence of the endometrial adenocarcinoma and the atrophy of the endometrium. Low level of ER expression in stromal cells in comparison with the glandular was demonstrated both in the foci of endometrial heterotopias and in eutopical endometrium in endometrial carcinoma. Low level of intensity of stromal component expression of the foci of endometrial heterotopias was found in the group with endometrial adenocarcinoma in comparison with the other groups. Further studying of the activity level of progesterone receptors in eutopical endometrium and in the foci of the internal endometriosis is perspective for this category of women.