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This study analyzed estrogen receptor content in endometrial tissue, finding that receptor density correlates with hormonal stimulation and tumor differentiation, which informs therapeutic strategies for functional disorders and ER-positive endometrial carcinomas.
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This study utilized immunohistochemistry to analyze estrogen receptor (ER) content in fresh endometrial tissue from 86 hysterectomy specimens and 6 curettages. The findings demonstrated that ER density correlates closely with endogenous hormonal stimulation and glandular proliferation, allowing for therapeutic recommendations in functional disorders without relying on serum hormone levels. Additionally, the research noted that while age-related atrophy retained detectable ER, contraceptive-induced atrophy did not, and ER presence in endometrial carcinomas varied by differentiation status, influencing the utility of anti-estrogen therapy. This paper is centrally about endometriosis — specifically, it investigates endometrial pathology and receptor status which are fundamental to understanding endometriosis-associated dysfunctions and malignancies.
Abstract
We studied immunohistochemically cryostat sections made from fresh endometrial tissue, immediately frozen after removal (86 hysterectomy specimens, 6 curettages) for their content of oestrogen receptors (ER) using the ER-ICA assay. Routine histological sections were prepared from parallel specimens of the endometria for determining endometrial functions. The evaluation of the immunohistiological preparations showed that the ER content in the endometrium was closely related to the endogenous hormone stimulation. A further refinement and differentiation of that relationship became possible and correlated well with the various forms of follicle and corpus-luteum insufficiencies. The results indicated that it is now possible to recommend therapy of functional disorders of the endometrium, esp. in sterility cases, without need or knowledge of serum hormone levels. As the endometrial glandular proliferation increases, the density of the ER becomes more intense. In contrast, under therapy with predominantly gestagenic preparations or after these are discontinued, the ER are decreased more than found in normal glands at that degree of proliferation. Whereas the atrophic endometria of old age contained greatly diminished but still detectable ER, no ER could be found in endometrial atrophy induced by oral contraceptives. Carcinomatous endometria revealed a heterogeneous distribution of ER. The better the tumour cells were differentiated, the greater was the density of the ER. By contrast, the carcinomas derived from metaplastic Müllerian epithelium contained few or no ER. This difference is of practical importance, since an adjuvant anti-oestrogen therapy seems of value only with ER-positive carcinomas. The immunohistochemical determination of ER is more exact than the biochemical determination, for each single cell can be evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)
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DOI: 10.1055/s-2008-1036285
Immunhistochemische Rezeptorbefunde im Endometrium und therapeutische Konsequenzen bei endogenen und exogenen Funktionsstörungen und im Karzinom
Changes in Hormone Receptors of the Endometrium in Endogenous and Exogenous Functional Disturbances and in Carcinoma: Immunohistochemical Studies and Therapeutic ConsequencesPublication History
Publication Date:
18 March 2008 (online)
Zusammenfassung
Kryostatsehnitte von sofort tiefgefrorenen Endometriumscheiben aus 86 Uteri und 6 Abradaten wurden immunhistochemisch nach dorn FR-ICA-Assay auf ihren Gehalt an Östrogenrezeptoren untersucht. Parallel entnommene Gewebsschciben wurden in Paraffin eingebettd zur Bestimmung der Endometriumfunktion im Rahmender üblichen histologischen Diagnostik.
Die immunhistochemischen Auswertungen ergaben einen engen Zusammenhang des Östrogenrezeptorgehaltes im Endometrium mit der endogenen hormonellen Stimulation. Dadurch wird, korrelierend zu den verschiedenen Formen der Follikel- und Corpus-luteum-Insuffizienz, z.B. bei der histologischen Sterilitätsdiagnose eine weitere Differenzierung möglich, aus der sich Therapieempfehlungen auch ohne Kenntnis der serologischen Hormonworte ableiten lassen. Mit zunehmendem Proliferationsgrad, insbesondere des Drüsenepithels, stieg die Rezeptordichte kontinuierlich an. Demgegenüber waren die ER unter Zufuhr gestagenbetonter Hormonpräparate oder nach deren Absetzen starker vermindert, als es dem Proliferationsgrad der Drüsen entsprochen hätte. Während das altersatrophische Endometrium zwar stark verminderte, aber immer noch nachweisbare ER enthielt, ließen sich in den postkontrazeptiven Endometriumatrophien keine ER mehr nachweisen. Im karzinomatösen Endometrium fand sich eine sehr heterogene Verteilung der HR. Die Zahl der ER war bei der endometrialen Form des Adenokarzinoms um so größer, je höher der Differenzierungsgrad der Zellen. Demgegenüber enthielten die von metaplastischem Müllerschen Epithel abzuleitenden Karzinome wenige oder keine ER. Auch diese Differenzierung ist von praktischer Bedeutung, da eine adjuvante anti- Östrogene Therapie nur bei den ER-positiven Karzinomen sinnvoll erscheint. Die immunhistochemische Bestimmung der ER ist präziser a!s der biochemische Nachweis, da jede einzelne Zelle erfaßt werden kann. Die ER ließen sich auch nach mehrmonatiger Lagerung des Gewebes bei -10 bis -20° C noch in gleicher Konzentration nachweisen wie am Frischmaterial.
Abstract
We studied immunohistochemically cryostat sections made from fresh endometrial tissue, immediately frozen after removal (86 hysterectomy specimens, 6 curettages) for their content of oestrogen receptors (ER) using the ER-ICA assay. Routine histological sections were prepared from parallel speeimens of the endometria for determining endometrial functions.
The evaluation of the irnmunohistiological preparations showed thatthe ER content in the endometrium was closely related to the endogenous hormone stimulation. A turther refinement and differentiation of that relationship became possible and correlated well with the various forms of follicle and corpus-luteum insufficiencies. The results indicated that it is now possible to recommend therapy of functional disorders of the endometrium, esp. in sterility cases, without need or knowledge of serum hormone levels.
As the endomelrial glandular proliferation increases, the density of the ER becomes more intense. In contrast, under therapy with predominantly gestagenic preparations or after these are disconlinued, the ER are decreased more than found in normal glands at that degree of proliferation. Whereas the atrophic endometria of old age contained greatly diminished but still detectable ER, no ER could be found in endometrial atrophy induced by oral contraceptives. Carcinomatous endometria revealed a heterogeneous distribution of FR. The better the tumour cells were differentiated, the greater was the density of the FR. By contrast, the carcinomas derived from metaplastic Müllerian epithelium contained few or no ER. This difference is of practical importance, since an adjuvant anti-oestrogen therapy seems of value only with ER-positive carcinomas. The immunohistochemical determination of ER is more exact than the biochemical delermination, for each Single cell can be evaluated. In addition, despite the storage of the endometria for several months at -10 to -20 degrees, they revealed the same density of ER as the initial fresh speeimens.
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