IMMUNOHISTOCHEMICAL CHARACTERISTICS OF HYPERPLASIA ENDOMETRY IN COMPARISON WITH SECRETORY ENDOMETRY
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14171Keywords:
endometrium, endometrial hyperplasia, endometrial hyperplasia without atypia, atypical endometrial hyperplasia, immunohistochemistry, prognosisAbstract
The aim of the study – is to compare the expression of immunohistochemical markers in three types of endometrium: endometrial hyperplasia without atypia, endometrial hyperplasia with atypia, and secretory endometrium, in order to determine the most informative markers that can serve as diagnostic supplements and prognostic indicators for the transition from endometrial hyperplasia to carcinoma.
Materials and Methods. The study was performed on endometrial biopsy material from 23 women of reproductive age with abnormal uterine bleeding by curettage, who were diagnosed with GE without/with atypia, 7 women made up the control group with endometrial secretory changes. A comparison was made of the expression of progesterone (PR) and estrogen (ER) receptors, as well as p21, dcl-2, KI-67, eNOS, cyclin D1, BAX, b-catenin, E-cadherin and Caspase 3 markers in order to determine the most informative markers that can serve as diagnostic adjuncts and prognostic indicators for the transition from GE to carcinoma.
Results and Discussion. The obtained results indicate a difference in the expression levels of immunohistochemical markers in different types of endometrium. These results are important for further investigation of the mechanisms of development of endometrial hyperplasia and may indicate potential therapeutic targets for the selection of treatment strategies for different types of hyperplasia.
Conclusions. The difference between the group of hyperplasias without atypia and the control group of secretory endometrium in the glandular component was demonstrated by markers ER, PgR, b-catenin, p21, cyclin D1, Ki-67, Caspasa-3, in the stromal component – ER, PgR, b-catenin, which gives reason to use them as the main diagnostic markers. The difference between the group of hyperplasia with atypia and the control group of secretory endometrium in the glandular component was demonstrated by markers ER, b-catenin, p21, cyclin D1, Ki-67, eNOS, in the stromal component – ER, b-catenin and eNOS, which gives reason to use them as the main diagnostic markers. The difference between the group of hyperplasias without atypia and the group of hyperplasias with atypia in the glandular component was demonstrated by markers PgR, Ki-67, Caspasa-3 eNOS, in the stromal component – eNOS, which gives reason to use them as the main diagnostic and prognostic markers. Bcl-2 and BAX markers did not show a statistically significant difference in the study groups, which indicates the impossibility of using them separately as diagnostic or prognostic markers for endometrial hyperplastic processes, and the interpretation of the expression results of these markers must be taken into account in combination with other indicators.
References
Ramos-Vara, J.A. (2017). Principles and Methods of Immunohistochemistry. Methods in Molecular Biology (Clifton, N.J.), 1641, 115-128. DOI: 10.1007/978-1-4939-7172-5_5. DOI: https://doi.org/10.1007/978-1-4939-7172-5_5
Sanderson, P.A., Critchley, H.O., Williams, A.R., Arends, M.J., & Saunders, P.T. (2017). New concepts for an old problem: the diagnosis of endometrial hyperplasia. Human Reproduction Update, 23(2), 232-254. DOI: 10.1093/humupd/dmw042. DOI: https://doi.org/10.1093/humupd/dmw042
Owings, R.A., & Quick, C.M. (2014). Endometrial intraepithelial neoplasia. Archives of Pathology and Laboratory Medicine, 138, 484-491. PMID: 24476505. DOI: https://doi.org/10.5858/arpa.2012-0709-RA
Hromova, O.L., Potapov, V.O., Khaskhachykh, D.A., Kukina, H.O., Haponova, O.V., & Penner, K.V. (2021). Retseptornyy status endometriyu pry hiperplastychnykh protsesakh u zhinok premenopauzalnoho viku [Receptor status of the endometrium in hyperplastic processes in premenopausal women]. Neonatolohiya, khirurhiya ta perynatalna medytsyna – Neonatology, surgery and perinatal medicine, 1(39), 33-38. DOI: 10.24061/2413-4260.XI.1.39.2021.5 [in Ukrainian]. DOI: https://doi.org/10.24061/2413-4260.XI.1.39.2021.5
Antunes, A., Vassallo, J., Pinheiro, A., Leao, R., Pinto Neto, A. M., & Costa-Paiva, L. (2014). Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps: A comparison between benign and malignant polyps in postmenopausal patients. Oncology Letters, 7(6), 1944-1950. DOI: 10.3892/ol.2014.2004. DOI: https://doi.org/10.3892/ol.2014.2004
Ahmed, R.H., Ahme, E., & Muhammad, M.S. (2014). E-cadherin and CD10 expression in atypical hyperplastic and malignant endometrial lesions. Journal of the Egyptian National Cancer Institute, 26(4), 211-217. DOI: 10.1016/j.jnci.2014.08.002. DOI: https://doi.org/10.1016/j.jnci.2014.08.002
Nees, L.K., Heublein, S., Steinmacher, S., Juhasz-Böss, I., Brucker, S., Tempfer, C.B., & Wallwiener, M. (2022). Endometrial hyperplasia as a risk factor of endometrial cancer. Arch. Gynecol. Obstet., 306(2), 407-421. DOI: 10.1007/s00404-021-06380-5. Epub 2022 Jan 10.PMID: 35001185. DOI: https://doi.org/10.1007/s00404-021-06380-5
de Groot, J.S., Ratze, M.A., van Amersfoort, M., Eisemann, T., Vlug, E.J., Niklaas, M.T., ... Derksen, P.W. (2018). αE-catenin is a candidate tumor suppressor for the development of E-cadherin-expressing lobular-type breast cancer. Journal of Pathology, 245(4), 456-467. DOI: 10.1002/path.5099. DOI: https://doi.org/10.1002/path.5099
Shevra, C.R., Ghosh, A., & Kumar, M. (2015). Cyclin D1 and Ki-67 expression in normal, hyperplastic, and neoplastic endometrium. Journal of Postgraduate Medicine, 61(1), 15-20. DOI: 10.4103/0022-3859.147025. DOI: https://doi.org/10.4103/0022-3859.147025
Najafi, T., Ghaffari Novin, M., Pakravesh, J., Foghi, K., Fadayi, F., & Rahimi, G. (2012). Immunohistochemical localization of endothelial nitric oxide synthase in endometrial tissue of women with unexplained infertility. Iranian journal of reproductive medicine, 10(2), 121-126. PMID: 25242984; PMCID: PMC4163273.
Silkova, O.V., & Lobach, N.V. (2016). Medychna informatyka: navchalnyy posibnyk [dlya studentiv vyshchykh navch. zakladiv MOZ Ukrayiny] – Medical informatics: a study guide [for students of higher education. institutions of the Ministry of Health of Ukraine]. MOZ Ukrayiny, UMSA PMID: 28203752 [in Ukrainian].
Bendifallah, S., Genin, A.S., Naoura, I., Chabbert-Buffet, N., & Bolze, P.A. (2018). The impact of endometrial thickness changes in patients with simple hyperplasia without atypia. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 224, 75-81. DOI: 10.1016/j.ejogrb.2018.04.032. DOI: https://doi.org/10.1016/j.ejogrb.2018.04.032
Bhattacharjee, M., Chakraborty, P., Mukherjee, A., & Mukherjee, S. (2019). Association of PTEN and progesterone receptor expressions in endometrial hyperplasia without atypia and early-stage endometrial adenocarcinoma. Journal of Mid-life Health, 10(3), 128DOI: 10.4103/jmh.JMH_47_19.
Dall'Agnol, M.A., & Dias, J.A. (2019). Endometrial hyperplasia: A review for clinical practice. Clinics, 74, e1189. DOI: 10.6061/clinics/2019/e1189.
Khaskhachykh, D.A., Potapov, V.O., & Kukina, H.O. (2019). Dyferentsiyovanyy pidkhid do likuvannya hiperplaziyi endometriyu bez atypiyi u zhinok reproduktyvnoho viku [A differentiated approach to the treatment of endometrial hyperplasia without atypia in women of reproductive age]. Aktualni pytannya pediatriyi, akusherstva ta hinekolohiyi – Current issues of pediatrics, obstetrics and gynecology, 2(24), 149-154. DOI: 10.11603/24116-4944.2019.2.10935 [in Ukrainian]. DOI: https://doi.org/10.11603/24116-4944.2019.2.10935
Huang, W., Liu, X., & Cao, G. (2019). Expression of serum CA-125, HE4, P53, and progesterone in patients with endometrial hyperplasia and endometrial cancer. Oncology Letters, 17(1), 1229-1234. DOI: 10.3892/ol.2018.9724. DOI: https://doi.org/10.3892/ol.2018.9724
Khaskhachykh, D., Potapov, V., & Poslavska, O (2023). Immunohistochemical Features of the Basal Layer of the Endometrium: Morphological Aspects. J. Gynecol. Women’s Health, 25(4), 556168. DOI: 10.19080/JGWH.2023.25.556168. DOI: https://doi.org/10.19080/JGWH.2023.25.556168
Kılıç, A., & Gultekin, M. (2019). Management of Endometrial Hyperplasia: Current Practice and Perspective. Geburtshilfe und Frauenheilkunde, 79(12), 1337-1343. DOI: 10.1055/a-1096-5365.
Kurman, R.J., & Carcangiu, M.L. (2014). WHO classification of tumors of female reproductive organs. International Agency for Research on Cancer. Retrieved from: https://catalog.nlm.nih.gov/discovery/search?vid=01NLM_INST:01NLM_INST&query=lds04,exact,101656343.
Khaskhachikh, D., Potapov, V., & Poslavska, O. (2023) Factors of resistance to progestin therapy in endometrial hyperplasia in women. Morphologia, 17(1), 56-62. DOI: 10.26641/1997-9665.2023.1.56-62.
Doherty, M.T., Sanni, O.B., Coleman, H.G., Cardwell, C.R., McCluggage, W.G., Quinn, D., & McMenamin, U.C. (2020). Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and meta-analysis. PloS One, 15(4), e0232231. DOI: 10.1371/journal.pone.0232231 DOI: https://doi.org/10.1371/journal.pone.0232231
Naftalin, J., Hoo, W. L., Nunes, N., Wong, Y. L., Gupta, J. K., & Hickey, M. (2019). Systematic review of the diagnosis and management of endometrial hyperplasia. Journal of Obstetrics and Gynaecology, 39(3), 321-331. DOI: 10.1080/01443615.2018.1521033.
Salker, M.S., Christian, M., & Steel, J.H., (2011). Deregulation of the serum- and glucocorticoid-inducible kinase SGK1 in the endometrium causes reproductive failure. Nature Medicine, 17(11), 1509-1513. DOI: 10.1038/nm.2514. DOI: https://doi.org/10.1038/nm.2498
Hromova, O.L., Potapov, V.O., Khaskhachykh, D.A., Fynkova, O.P., Haponova, O.V., & Kukina, H.O. (2021). Epigenetic profile of endometrial proliferation in the different morphotypes of endometrial hyperplasia. Reproductive Endocrinology, 57, 68-78. DOI: 10.18370/2309-4117.2021.57.68-78. DOI: https://doi.org/10.18370/2309-4117.2021.57.68-78
Khaskhachykh, D., Potapov, V., & Harahulya, I. (2022). Rol biomarkeriv dlya diahnostyky, dyferentsialnoyi diahnostyky i vyboru likuvalnoyi stratehiyi pry hiperplaziyi i raku endometriya u zhinok [The role of biomarkers for diagnosis, differential diagnosis and selection of a treatment strategy for endometrial hyperplasia and cancer in women]. Grail of Science, 18-19, 372-385. DOI: 10.36074/grail-of-science.26.08.2022.60 [in Ukrainian]. DOI: https://doi.org/10.36074/grail-of-science.26.08.2022.60
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Actual Problems of Pediatrics, Obstetrics and Gynecology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
