Characteristics of endometrial hormonal homeostasis and receptor apparatus in women with adenomyosus who had papillary thyroid carcinoma

In: REPRODUCTIVE ENDOCRINOLOGY · 2022 · pp. 101–106 · doi:10.18370/2309-4117.2022.65.101-106 · W4308267274
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Endometrial glandular and stromal cells showed high expression of ER-α and PgR in women with adenomyosis and a history of papillary thyroid carcinoma, with significantly higher ER-α expression in stromal cells in the cancer survivor group.

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This study evaluated hormonal status and eutopic endometrial estrogen and progesterone receptor expression in 63 women with adenomyosis, comparing 31 patients with a history of papillary thyroid carcinoma to 32 patients with no thyroid cancer history. Peripheral serum hormone levels were measured, and eutopic endometrium was assessed by endometrial pipelle biopsy with immunohistochemistry for ER-α and PgR, with pelvic pain severity recorded via visual analog scale. ER-α was frequently expressed in glandular epithelial cells and stromal cells, and stromal ER-α and PgR positivity in both compartment types differed significantly between groups, with the thyroid-cancer history group showing higher PgR and ER-α positivity in stromal cells (while also reporting an overall pattern of high receptor expression). The paper’s main limitation is that it reports receptor expression and serum hormones without establishing causal mechanisms or outcomes. This paper is centrally about endometriosis and/or adenomyosis — it specifically characterizes hormonal homeostasis and ER/PgR expression in women with adenomyosis, stratified by prior papillary thyroid carcinoma history.

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Abstract

Objectives: to evaluate the hormonal status and receptor apparatus of the eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma.Materials and methods. 63 women were examined: group I consisted of 31 patients with adenomyosis and papillary carcinoma of the thyroid gland in history, group II consisted of 32 patients with adenomyosis and unencumbered thyroid status. The severity of pelvic pain was assessed using a visual analog scale. The level of luteinizing and follicle-stimulating hormones, estradiol, prolactin, thyroid-stimulating hormone and progesterone was determined in the peripheral blood serum. The material for the morphological study was obtained using endometrial pipelle biopsy. Morphological research was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). Immunohistochemical study was performed on 20 paraffin sections (10 samples from patients of group I and 10 samples from patients of group II) using monoclonal antibodies.Results. High ER-α expression was detected in the endometrial glandular epithelial cells (EGECs) in 80 and 50% of samples of patients from groups I and II, respectively (р < 0.05), no significant difference in the number of positive cells was found between groups. High ER-α expression in endometrial stromal cells (ESCs) was detected in 50% of samples in patients from both groups, the number of positive cells was significantly higher in the endometrium specimens from I group (84.0 (10.5%) in group I versus 62.2 (12.3%) in group II, р < 0.05). High PgR expression in the EGECs was detected in 90 and 75% of samples in groups I and II respectively (р < 0.05), ESCs expressed PgR in 100% of samples of patients from both groups. Significant difference in the number of positive cells was found between groups – 96.0 (8.4%) and 84.9 (12.6%) in groups I and II respectively, р < 0.05.Conclusions. Our results suggest that the ectopic endometrium in female thyroid cancer survivors with adenomyosis has high expression of ER and PgR, that may have important implications for the survival and proliferation of the eutopic endometrial cells. Further research is needed to optimise prevention and treatment algorithms for this group of patients.
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Objectives

to evaluate the hormonal status and receptor apparatus of the eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma.

Materials

and methods. 63 women were examined: group I consisted of 31 patients with adenomyosis and papillary carcinoma of the thyroid gland in history, group II consisted of 32 patients with adenomyosis and unencumbered thyroid status. The severity of pelvic pain was assessed using a visual analog scale. The level of luteinizing and follicle-stimulating hormones, estradiol, prolactin, thyroid-stimulating hormone and progesterone was determined in the peripheral blood serum. The material for the morphological study was obtained using endometrial pipelle biopsy. Morphological research was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). Immunohistochemical study was performed on 20 paraffin sections (10 samples from patients of group I and 10 samples from patients of group II) using monoclonal antibodies. Results. High ER-α expression was detected in the endometrial glandular epithelial cells (EGECs) in 80 and 50% of samples of patients from groups I and II, respectively (р < 0.05), no significant difference in the number of positive cells was found between groups. High ER-α expression in endometrial stromal cells (ESCs) was detected in 50% of samples in patients from both groups, the number of positive cells was significantly higher in the endometrium specimens from I group (84.0 (10.5%) in group I versus 62.2 (12.3%) in group II, р < 0.05). High PgR expression in the EGECs was detected in 90 and 75% of samples in groups I and II respectively (р < 0.05), ESCs expressed PgR in 100% of samples of patients from both groups. Significant difference in the number of positive cells was found between groups – 96.0 (8.4%) and 84.9 (12.6%) in groups I and II respectively, р < 0.05. Conclusions. Our results suggest that the ectopic endometrium in female thyroid cancer survivors with adenomyosis has high expression of ER and PgR, that may have important implications for the survival and proliferation of the eutopic endometrial cells. Further research is needed to optimise prevention and treatment algorithms for this group of patients.

References

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