The role of estrogen and progesterone receptors in women with adenomyosis in postmenopause

In: Reports of Vinnytsia National Medical University · 2019 · vol. 23(1) , pp. 148–152 · doi:10.31393/reports-vnmedical-2019-23(1)-26 · W2962419545
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This study investigated estrogen and progesterone receptor expression in eutopic and ectopic endometrium of postmenopausal women with adenomyosis, finding hormonal dependence and a predominance of progesterone's role in pathogenesis.

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This paper studied women with postmenopausal adenomyosis to determine the role of estrogen (ER) and progesterone (PR) receptor expression in the pathogenesis of internal endometriosis–like lesions. Using immunohistochemistry on both eutopic (normal) and ectopic endometrium, the authors reported ER and PR expression in epithelial and stromal cells, with about one-third of women showing a normal ER/PR correlation in eutopic endometrium, while in stromal cells ER was decreased with PR increased (ER/PR < 1) in 9 of 15 patients; they also found PR-predominant involvement in ectopic endometrium characterized by increased PR and decreased ER. The study’s caveat is that it uses receptor expression patterns from a specific immunohistochemical assessment and does not establish causality for receptor changes. This paper is centrally about adenomyosis — it focuses on ER/PR receptor expression patterns in postmenopausal adenomyosis.

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Abstract

Adenomyosis (AD) is an urgent medical problem of the present. The issues of etiology and pathogenesis of internal endometriosis remain controversial. The purpose of the work is to define the role of estrogen (ER) and progesterone (PR) receptors in the pathogenesis of adenomyosis (AD) in postmenopausal women. Selection criteria: established diagnosis of AD, postmenopausal period (no menstruation for more than 1 year) and absence of concomitant endometrial pathology. An immunohistochemical (IHС) study was performed to determine the state of the receptor apparatus for markers of estrogen and progesterone. The IНC study of the eu- and ectopic endometrium receptor apparatus revealed the presence of ER and RR expression both in epithelial cells and stromal cells, indicating the hormonal dependence of AD foci and the key role of steroid hormones in the development and preservation of intraocular endometriosis in postmenopausal women. Nearly a third of women in the epithelial cells of the eutopic endometrium found a normal correlation between ER and PR, respectively leading to 1. In stromal cells, a decrease in ER was observed with an increase in RR (ER / PR <1) in 9 out of 15 patients. Analysis of the distribution of the ratio of expression ratios of ER and PR in ectopic endometrium revealed the predominance of the role of PR in ER in the pathogenesis of internal endometriosis. The components of the ectopic endometrium in most women were characterized by an increase in PR and a decrease in ER (ER / PR <1).
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The role of estrogen and progesterone receptors in women with adenomyosis in postmenopause DOI: https://doi.org/10.31393/reports-vnmedical-2019-23(1)-26Keywords: adenomyosis, postmenopause, estrogen and progesterone receptors.Abstract Adenomyosis (AD) is an urgent medical problem of the present. The issues of etiology and pathogenesis of internal endometriosis remain controversial. The purpose of the work is to define the role of estrogen (ER) and progesterone (PR) receptors in the pathogenesis of adenomyosis (AD) in postmenopausal women. Selection criteria: established diagnosis of AD, postmenopausal period (no menstruation for more than 1 year) and absence of concomitant endometrial pathology. An immunohistochemical (IHС) study was performed to determine the state of the receptor apparatus for markers of estrogen and progesterone. The IНC study of the eu- and ectopic endometrium receptor apparatus revealed the presence of ER and RR expression both in epithelial cells and stromal cells, indicating the hormonal dependence of AD foci and the key role of steroid hormones in the development and preservation of intraocular endometriosis in postmenopausal women. Nearly a third of women in the epithelial cells of the eutopic endometrium found a normal correlation between ER and PR, respectively leading to 1. In stromal cells, a decrease in ER was observed with an increase in RR (ER / PR <1) in 9 out of 15 patients. Analysis of the distribution of the ratio of expression ratios of ER and PR in ectopic endometrium revealed the predominance of the role of PR in ER in the pathogenesis of internal endometriosis. The components of the ectopic endometrium in most women were characterized by an increase in PR and a decrease in ER (ER / PR <1). Downloads References 2. Adamyan, L. V., Andreeva, E. N., Apolihina, I. 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