The Relationship Among HOXA10, Estrogen Receptor α, Progesterone Receptor, and Progesterone Receptor B Proteins in Rectosigmoid Endometriosis: A Tissue Microarray Study

Alysson Zanatta, Ricardo Pereira, Ricardo Mendes Alves Pereira, André Monteiro da Rocha, Bruno Cogliati, Edmund Chada Baracat, Hugh S Taylor, E.L.A. Motta, Eduardo Leme Alves da Motta, Paulo Cesar Serafini, P. Serafini
Reproductive sciences (Thousand Oaks, Calif.) · 2014 · vol. 22(1) , pp. 31–37 · doi:10.1177/1933719114549846 · PMID:25217304 · W2039297208
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

This study quantified HOXA10, ER-α, PR, and PR-B protein expression in rectosigmoid endometriosis, finding HOXA10 expression in the secretory phase and significantly greater PR/PR-B expression during that phase.

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This tissue microarray study evaluated protein expression of HOXA10, estrogen receptor α (ER-α), progesterone receptor (PR), and PR-B specifically in rectosigmoid deep endometriosis from 18 consecutive patients, with samples collected during the proliferative and secretory phases and assessed by immunohistochemistry using a modified Allred score. HOXA10 was detected in the stroma of nodules in 5/18 patients during the secretory phase, while ER-α, PR, and PR-B showed moderate-to-strong expression in both glands and stroma during both menstrual phases; additionally, PR and PR-B were significantly higher in the secretory phase (P = .023 and P = .024). A key limitation is the small cohort size (n=18) and the cross-sectional tissue expression design without direct mechanistic validation. This paper is centrally about endometriosis — it focuses on HOXA10 and steroid receptor expression patterns in rectosigmoid (deep infiltrating) endometriosis.

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Abstract

Background Very few studies have evaluated the expression of homeobox A10 (HOXA10) and steroid (estrogen and progesterone) receptors exclusively in deep endometriosis. Conclusions drawn from studies evaluating peritoneal and ovarian endometriosis are usually generalized to explain the pathogenesis of the disease as a whole. We aimed to evaluate the expression of HOXA10, estrogen receptor α (ER-α), progesterone receptor (PR), and PR-B in rectosigmoid endometriosis (RE), a typical model of deep disease.

Methods

We used RE samples from 18 consecutive patients to construct tissue microarray blocks. Nine patients each were operated during the proliferative and secretory phases of the menstrual cycle. We quantified the expressions of proteins by immunohistochemistry using the modified Allred score.

Result

The HOXA10 was expressed in the stroma of nodules during the secretory phase in 5 of the 18 patients. Expression of ER-α (in 16 of 18 patients), PR (in 17 of 18 patients), and PR-B (17 of 18 patients) was moderate to strong in the glands and stroma of nodules during both phases. Expression of both PR (P = .023) and PR-B (P = .024) was significantly greater during the secretory phase.

Conclusion

The HOXA10 is expressed in RE, where it likely imparts the de novo identity of endometriotic lesions. The ER-α, PR, and PR-B are strongly expressed in RE, which differs from previous studies investigating peritoneal and ovarian lesions. This suggests different routes of pathogenesis for each of the 3 types of endometriosis. Similar content being viewed by others

References

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometrium Estrogen Receptor alpha Homeodomain Proteins Receptors, Progesterone Rectal Diseases Sigmoid Diseases Tissue Array Analysis Adult Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Epithelial Cells Epithelial Cells Estrogen Receptor alpha Female Homeobox A10 Proteins

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