Proliferative activity of postmenopausal endometriosis: a histopathologic and immunocytochemical study

T Toki, Toki T, A Horiuchi, Horiuchi A, Li SF, S F Li, Nakayama K, K Nakayama, S G Silverberg, Silverberg SG, S Fujii, Fujii S
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 1996 · doi:10.1097/00004347-199601000-00008 · PMID:8852446
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Postmenopausal endometriosis lesions showed proliferative activity and retained hormonal responsiveness, with higher Ki-67 positivity in stromal cells compared to eutopic endometrium.

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This study examined the histological and immunocytochemical characteristics of 21 postmenopausal endometriosis cases alongside their corresponding eutopic endometrium. The researchers analyzed estrogen receptor, progesterone receptor, and Ki-67 expression to assess hormonal responsiveness and proliferative activity within the lesions. Findings indicated that endometriotic foci retained both epithelial and stromal components with significant proliferative markers, contrasting with the atrophic features typically seen in the surrounding uterine lining. Although all patients had concurrent gynecologic diseases that obscured preoperative diagnosis, the data confirmed that these lesions remain biologically active despite low estrogen levels. This paper is centrally about endometriosis — specifically investigating the persistent hormonal sensitivity and cellular proliferation of deep infiltrating or superficial implants in postmenopausal women.

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Abstract

Histological features of 21 cases of postmenopausal endometriosis as well as the corresponding eutopic endometrium were studied. Immunocytochemical analysis of estrogen receptor (ER), progesterone receptor (PR), and Ki-67 nuclear antigen was also performed on the endometriotic lesions as well as the corresponding endometrium. All the cases studied were complicated by various other gynecologic diseases, making the preoperative diagnosis of endometriosis unlikely. Histologically, the endometriotic foci contained both epithelial and stromal components mostly lacking atrophic features in contrast to the corresponding eutopic endometrium. The endometriotic lesions and the corresponding endometrium exhibited immunoreactivity with ER in both the glands and stroma. The stromal cells of endometriotic lesions revealed positive PR staining, whereas those of the eutopic endometrium were either negative or weakly positive for PR, but the epithelial components of both were positive for PR. The positivity of Ki-67 antigen tended to be higher in the stroma of the postmenopausal endometriosis than in the eutopic endometrial stroma. Endometriotic lesions appear to remain biologically active, with proliferative activity as well as retained hormonal responsiveness, even in the low-estrogen milieu of the postmenopausal age.
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Proliferative Activity of Postmenopausal Endometriosis: A Histopathologic and Immunocytochemical Study - Toshihiko Toki - Akiko Horiuchi - Shuan-fang Li - Kuniaki Nakayama - Steven G. Silverberg - Shingo Fujii Summary: Histological features of 21 cases of postmenopausal endometriosis as well as the corresponding eutopic endometrium were studied. Immunocytochemical analysis of estrogen receptor (ER), progesterone receptor (PR), and Ki-67 nuclear antigen was also performed on the endometriotic lesions as well as the corresponding endometrium. All the cases studied were complicated by various other gynecologic diseases, making the preoperative diagnosis of endometriosis unlikely. Histologically, the endometriotic foci contained both epithelial and stromal components mostly lacking atrophic features in contrast to the corresponding eutopic endometrium. The endometriotic lesions and the corresponding endometrium exhibited immunoreactivity with ER in both the glands and stroma. The stromal cells of endometriotic lesions revealed positive PR staining, whereas those of the eutopic endometrium were either negative or weakly positive for PR. but the epithelial components of both were positive for PR. The positivity of Ki-67 antigen tended to be higher in the stroma of the postmenopausal endometriosis than in the eutopic endometrial stroma. Endometriotic lesions appear to remain biologically active, with proliferative activity as well as retained hormonal responsiveness, even in the lowestrogen milieu of the postmenopausal age.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Postmenopause Adult Aged Cell Division Endometriosis Female Humans Immunohistochemistry Immunohistochemistry Ki-67 Antigen Ki-67 Antigen Middle Aged Receptors, Estrogen Receptors, Estrogen Receptors, Progesterone Receptors, Progesterone Uterus Uterus

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