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Open Access Highly Accessed Research

Distribution of estrogen and progesterone receptors isoforms in endometrial cancer

Hila Kreizman-Shefer1, Jana Pricop1, Shlomit Goldman2, Irit Elmalah1 and Eliezer Shalev23*

Author Affiliations

1 Emek Cancer Diagnosis and Research Institute (ECDRI), Emek Medical Center, Afula, Israel

2 Laboratory for Research in Reproductive Sciences and Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel

3 Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

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Diagnostic Pathology 2014, 9:77  doi:10.1186/1746-1596-9-77

Published: 31 March 2014

Abstract

Background

70–80% of sporadic endometrial carcinomas are defined as endometrioid carcinoma (EC). Early-stage, well differentiated endometrial carcinomas usually retain expression of estrogen and progesterone receptors (ER and PR, respectively), as advanced stage, poorly differentiated tumors often lack one or both of these receptors. Well-described EC prognosis includes tumor characteristics, such as depth of myometrial invasion. Therefore, in the current study, we evaluated the expression profile of ER and PR isoforms, including ER-α, PR-A and PR–B, in correlation to EC tumor histological depth.

Methods

Using immunohistochemistry and image analysis software, the expression of ER-α, PR-A, PR–B and Ki67 was assessed in endometrial stroma and epithelial glands of superficial, deep and extra-tumoral sections of 15 paraffin embedded EC specimens, and compared to 5 biopsies of non-malignant endometrium.

Results

Expression of PR-A and ER-α was found to be lower in EC compared to nonmalignant tissue, as the stromal expression was dramatically reduced compared to epithelial cells. Expression ratios of both receptors were significantly high in superficial and deep portions of EC; in non-tumoral portion of EC were close to the ratios of nonmalignant endometrium. PR-B expression was low in epithelial glands of EC superficial and deep portions, and high in the extra-tumoral region. Elevated PR-B expression was found in stroma of EC, as well.

Conclusions

The ratio of ER-α and PR-A expression in the epithelial glands and the stroma of EC biopsies may serve as an additional parameter in the histological evaluation of EC tumor.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1155060506119016 webcite

Keywords:
Endometrial carcinoma; Estrogen receptor; Progesterone receptor