Progesterone Receptor Status of Epithelial Cells as a Predictive Marker for Postoperative Recurrence of Endometriosis

Yosuke Tarumi, Taisuke Mori, Koki Shimura, Shimura K, Izumi, Yuko, Yuko Izumi, Hiroyuki Okimura, Okimura H, Hisashi Kataoka, Tetsuya Kokabu, Ito F, Fumitake Ito, Akemi Koshiba, Koshiba A, Khaleque N Khan, Khan KN, Khaleque Newaz Khan, Kusuki I, Izumi Kusuki, Kitawaki J, Jo Kitawaki
The Journal of clinical endocrinology and metabolism · 2022 · vol. 107(6) , pp. 1552–1559 · doi:10.1210/clinem/dgac118 · PMID:35235655 · W4214856021
article OA: bronze CC0 ⤵ 5 in-corpus citations
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Low progesterone receptor expression in epithelial cells of ovarian endometriomas is associated with a higher risk of postoperative endometriosis recurrence.

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Abstract

CONTEXT: Progesterone resistance including progesterone receptor (PR) deficiency contributes to the pathophysiology of endometriosis; however, whether the PR expression levels in ovarian endometrioma (OE) correlate with the postoperative recurrence of endometriosis remains unclear. OBJECTIVE: This study aimed to investigate the association between PR expression levels in OE and the recurrence of endometriosis. METHODS: OE specimens were obtained from 132 patients who underwent conservative surgery for endometriosis. The PR expression levels were evaluated using the H score after immunohistochemical staining. RESULTS: Of the 132 patients, 36 (27.3%) experienced recurrence and 96 (72.7%) did not. No differences were observed in the patient characteristics between the recurrence and nonrecurrence groups except for follow-up period. PR immunoreactivity in the epithelial cells (ECs) was statistically significantly lower in the recurrent group than in the nonrecurrent group (P < .01); however, this change was not observed in the stromal cells. Moreover, multivariable logistic regression analysis revealed that the H score of PR in ECs was an independent factor and was statistically significantly associated with the recurrence of endometriosis (P = .01). Furthermore, we divided the patients into PR-negative or PR-positive groups. The cumulative recurrence rate in the negative PR group was statistically significantly higher than that in the positive PR group (P = .046). CONCLUSION: Low PR expression levels in OE-ECs may predict the recurrence of endometriosis. The PR status in OE-ECs is associated with the pathophysiology of the recurrence of endometriosis, and optimized postoperative management for endometriosis may be provided by referring to the PR status.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Uterine Diseases Biomarkers Biomarkers Endometrium Endometrium Epithelial Cells Epithelial Cells Female Humans Receptors, Progesterone Receptors, Progesterone

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