Distribution Pattern of ER & PR Immunoexpression in Endometrial Biopsies of DUB and Infertile Patients from A Tertiary Care Centre
Keywords:
Endometrium, DUB, Infertility, Quick score
Abstract
Objective: To study endometrial estrogen and progesterone immunoexpression in different phases of menstrual cycle, in cases of dysfunctional uterine bleeding and infertility. A comparative analysis was also done for calculating ER & PR expression, between two methods: quick score and percentage of immunopositive cells.Methods: Endometrial biopsies from 107 clinically diagnosed DUB cases and 23 infertile patients were included in the study. Tissue sections were analyzed for different phases of menstrual cycle and immunoexpression of ER & PR receptors was calculated in glandular epithelium and stromal cells, using percentage of positively stained cells and Quick score method. Endometrial sections of hysterectomy specimens of uterovaginal prolapse cases were used as control sections.Result: In the present analysis, secretory endometrium was the commonest finding histopathologically. Mean total ER & PR expression in cases of DUB was statistically higher in the proliferative phase using both methods (p<0.05). Mean total ER expression difference in both the phases of infertility cases was not statistically significant by the observation of percentage of positively stained cells. However, quick score revealed significant difference between both receptor expression in infertile patients.Conclusion:The percentage of positive cells for ER and PR expression plays a more determinant role in studying ER and PR expression in cases of DUB and infertility as compared to quick score. DOI: 10.21276/APALM.1374References
1. Rosai J. Female reproductive system. Uterus-corpus. In: Rosai and Ackerman’s Surgical Pathology. Vol 2. 9th ed. New Delhi: Elsevier; 2004. p. 1569-635.
2. Dallenbach-Hellweg G. The Endometrium of Infertility. A Review. Pathol Res Pract 1984;178(6):527-37.
3. Chakraborty S, Khurana N, Sharma JB, Chaturvedi KU. Endometrial hormone receptors in women with dysfunctional uterine bleeding. Arch Gynecol Obstet 2005;272(1):17-22.
4. Mylonas I, Jeschke U, Shabani N, Kuhn C, Balle A, Kriegel S, et al. Immunohistochemical analysis of estrogen receptor alpha, estrogen receptor beta and progesterone receptor in normal human endometrium. Acta Histochem 2004;106(3):245-52.
5. Chakravarthy VK, Nag U, Rangarao D, Anusha AM. Estrogen and progesterone receptors in dysfunctional uterine bleeding. IOSR-JDMS 2013;4(3):73-6.
6. Gleeson N, Jordan M, Sheppard B, Bonnar J. Cyclical variation in endometrial oestrogen and progesterone receptors in women with normal menstruation and dysfunctional uterine bleeding. Eur J Obstet Gynecol Reprod Biol 1993;48(3):207-14.
7. Dadhania B, Dhruva G, Agravat A, Pujara K. Histopathological study of endometrium in dysfunctional uterine bleeding. J Int Med Res 2013;2(1):20-4.
8. Gupta A, Rathore AM, Manaktala U, Rudingwa P. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. IJBAR 2013;4(8):509-13.
9. Emokpae MA, Uadia PO, Mohammed AZ. Hormonal evaluation and endometrial biopsy in infertile women in Kano, Northern Nigeria: A comparative study. Ann Afr Med 2005;4(3):99-103.
10. Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull 2011;33(4):1-6.
11. Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Paramar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: what was and what is?. Indian J Pathol Microbiol 2009;52(2):171-4.
12. Press MF, Udove JA, Greene GL. Progesterone receptor distribution in the human endometrium. Analysis using monoclonal antibodies to the human progesterone receptor. Am J Pathol 1988;131(1):112-24.
13. Snijders MP, de Goeij AF, Debets-Te Baerts MJ, Rousch MJ, Koudstaal J, Bosman FT. Immunocytochemical analysis of oestrogen receptors and progesterone receptors in the human uterus throughout the menstrual cycle and after the menopause. J Reprod Fertil 1992;94(2):363–71.
14. Garcia E, Bouchard P, De Brux J, Berdah J, Frydman R, Schaison G, et al. Use of immunocytochemistry of progesterone and estrogen receptors for endometrial dating. J Clin Endocrinol Metab 1988;67(1):80-7.
15. Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Paramar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: what was and what is?. Indian J Pathol Microbiol 2009;52(2):171-4.
16. Lessey BA, Killiam AP, Metzger DA, Haney AF, Greene GL, McCarty KS. Immunohistochemical analysis of human uterine estrogen and progesterone receptors throughout the menstrual cycle. J Clin Endocrinol Metab 1988;67(2):334-40.
17. Gleeson N, Jordan M, Sheppard B, Bonnar J. Cyclical variation in endometrial oestrogen and progesterone receptors in women with normal menstruation and dysfunctional uterine bleeding. Eur J Obstet Gynecol Reprod Biol 1993;48(3):207-14.
18. Wells CA, Sloane JP, Coleman D, Munt C, Amendoeira I, Apostolikas N, et al. Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the Europian Union: an inter-laboratory study. Virchows Arch 2004;445(2):119-28.
19. Margarit L, Taylor A, Roberts MH, Hopkins L, Davies C, Brenton AG, et al. MUC1 as a descriminator between endometrium from fertile and infertile patients with PCOS and endometriosis. J Clin Endocrinol Metab 2010;95(12):5320-9.
20. Papanikalaou EG, Bourgain C, Kolibianakis E, Tournaye H, Devroey P. Steroid receptor expression in late follicular phase endometrium in GnRH antagonist IVF cycles is already altered, indicating of early luteal phase transformation in the absence of secretory changes. Hum Reprod 2005;20(6):1541-7.
2. Dallenbach-Hellweg G. The Endometrium of Infertility. A Review. Pathol Res Pract 1984;178(6):527-37.
3. Chakraborty S, Khurana N, Sharma JB, Chaturvedi KU. Endometrial hormone receptors in women with dysfunctional uterine bleeding. Arch Gynecol Obstet 2005;272(1):17-22.
4. Mylonas I, Jeschke U, Shabani N, Kuhn C, Balle A, Kriegel S, et al. Immunohistochemical analysis of estrogen receptor alpha, estrogen receptor beta and progesterone receptor in normal human endometrium. Acta Histochem 2004;106(3):245-52.
5. Chakravarthy VK, Nag U, Rangarao D, Anusha AM. Estrogen and progesterone receptors in dysfunctional uterine bleeding. IOSR-JDMS 2013;4(3):73-6.
6. Gleeson N, Jordan M, Sheppard B, Bonnar J. Cyclical variation in endometrial oestrogen and progesterone receptors in women with normal menstruation and dysfunctional uterine bleeding. Eur J Obstet Gynecol Reprod Biol 1993;48(3):207-14.
7. Dadhania B, Dhruva G, Agravat A, Pujara K. Histopathological study of endometrium in dysfunctional uterine bleeding. J Int Med Res 2013;2(1):20-4.
8. Gupta A, Rathore AM, Manaktala U, Rudingwa P. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. IJBAR 2013;4(8):509-13.
9. Emokpae MA, Uadia PO, Mohammed AZ. Hormonal evaluation and endometrial biopsy in infertile women in Kano, Northern Nigeria: A comparative study. Ann Afr Med 2005;4(3):99-103.
10. Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull 2011;33(4):1-6.
11. Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Paramar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: what was and what is?. Indian J Pathol Microbiol 2009;52(2):171-4.
12. Press MF, Udove JA, Greene GL. Progesterone receptor distribution in the human endometrium. Analysis using monoclonal antibodies to the human progesterone receptor. Am J Pathol 1988;131(1):112-24.
13. Snijders MP, de Goeij AF, Debets-Te Baerts MJ, Rousch MJ, Koudstaal J, Bosman FT. Immunocytochemical analysis of oestrogen receptors and progesterone receptors in the human uterus throughout the menstrual cycle and after the menopause. J Reprod Fertil 1992;94(2):363–71.
14. Garcia E, Bouchard P, De Brux J, Berdah J, Frydman R, Schaison G, et al. Use of immunocytochemistry of progesterone and estrogen receptors for endometrial dating. J Clin Endocrinol Metab 1988;67(1):80-7.
15. Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Paramar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: what was and what is?. Indian J Pathol Microbiol 2009;52(2):171-4.
16. Lessey BA, Killiam AP, Metzger DA, Haney AF, Greene GL, McCarty KS. Immunohistochemical analysis of human uterine estrogen and progesterone receptors throughout the menstrual cycle. J Clin Endocrinol Metab 1988;67(2):334-40.
17. Gleeson N, Jordan M, Sheppard B, Bonnar J. Cyclical variation in endometrial oestrogen and progesterone receptors in women with normal menstruation and dysfunctional uterine bleeding. Eur J Obstet Gynecol Reprod Biol 1993;48(3):207-14.
18. Wells CA, Sloane JP, Coleman D, Munt C, Amendoeira I, Apostolikas N, et al. Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the Europian Union: an inter-laboratory study. Virchows Arch 2004;445(2):119-28.
19. Margarit L, Taylor A, Roberts MH, Hopkins L, Davies C, Brenton AG, et al. MUC1 as a descriminator between endometrium from fertile and infertile patients with PCOS and endometriosis. J Clin Endocrinol Metab 2010;95(12):5320-9.
20. Papanikalaou EG, Bourgain C, Kolibianakis E, Tournaye H, Devroey P. Steroid receptor expression in late follicular phase endometrium in GnRH antagonist IVF cycles is already altered, indicating of early luteal phase transformation in the absence of secretory changes. Hum Reprod 2005;20(6):1541-7.
Published
2017-12-11
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
