Histopathology and steroid receptors in endometrial polyps of postmenopausal patients under hormone‐replacement therapy

Maia, Hugo; Maltez, Amélia; Calmon, Luis C.; Oliveira, Maita; Marques, D.; Coutinho, Elsimar Metzker

doi:10.1046/j.1365-2508.1998.00198.x

Cited by 29 publications

(26 citation statements)

References 14 publications

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“…A positive correlation between unopposed estrogen and endometrial proliferation has been demonstrated histologically in both benign and malignant endometrium [14] . A limited number of studies have addressed ER and PR expression in endometrial polyps [2,7,10,15] . The higher expression of ER in postmenopausal endometrial polyps than atrophic endometrium in this and some other studies suggests a role for estrogen in the pathogenesis of endometrial polyps as a hyperplastic process.…”

Section: Discussionmentioning

confidence: 99%

Hormone Receptor Expressions and Proliferation Markers in Postmenopausal Endometrial Polyps

İnceboz

Neşe²,

Uyar³

et al. 2006

Gynecol Obstet Invest

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Background/Aims: Endometrial polyps are quite common in the general population, they have a significant role in postmenopausal bleeding, and the pathogenesis is unclear. The aim of this study was to investigate proliferation markers and expression of estrogen and progesterone receptors in endometrial polyps in postmenopausal women. Methods: Endometrial polyps were removed by hysteroscopy from 36 women who presented with postmenopausal bleeding. None were using hormonal therapy. The control group consisted of 16 inactive-atrophic postmenopausal endometrial specimens removed at hysterectomy. Immunohistochemistry was used to demonstrate expression of estrogen and progesterone receptors and the cell growth and apoptosis markers, Ki67, bcl-2, c-erbB-2. Results: In both the glandular epithelium and stroma of endometrial polyps, estrogen and progesterone receptors, Ki67 and bcl-2 showed significantly more positive staining than the inactive endometrium from the control group. There was no difference in expression of c-erbB-2 between the two groups. Conclusions: Estrogen may have a role in the development of postmenopausal endometrial polyps, either by direct stimulation of localized proliferation or by stimulation of proliferation via other pathways, such as activation of Ki67 or through inhibition of apoptosis via bcl-2. c- erbB-2 is unlikely to play any role in development of these lesions.

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Section: Discussionmentioning

confidence: 99%

Hormone Receptor Expressions and Proliferation Markers in Postmenopausal Endometrial Polyps

İnceboz

Neşe²,

Uyar³

et al. 2006

Gynecol Obstet Invest

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“…A relationship between estrogens, increased expression of endometrial hormonal receptors, (HRs) and endometrial stimulation is already accepted [8, 9]. In the last years it has been suggested that estrogens can cause the EPs growth by failure of proapoptotic mechanisms (an overexpression of Bcl-2 was reported in premenopausal and postmenopausal endometria) as well as by an increase in local levels of growth factors (GFs) such as fibroblastic GF, transforming GF-a, epithelial GF, IGF-1, and GF receptors within the endometrium which may promote polyp growth [5, 8].…”

Section: Introductionmentioning

confidence: 99%

Endometrial Polyps in Women Affected by Levothyroxine-Treated Hypothyroidism—Histological Features, Immunohistochemical Findings, and Possible Explanation of Etiopathogenic Mechanism: A Pilot Study

Saccardi

Gizzo

Ludwig

et al. 2013

BioMed Research International

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The aim of the study was to investigate the possible overexpression of estrogen (ERs) and progesterone (PRs) receptors both in EPs glandular and stromal cells in postmenopausal women with levothyroxine-treated hypothyroidism in comparison to EPs detected in women with physiological thyroid hormone levels. During the study period (January-February 2013) 22 patients were eligible (12 treated, 10 controls). The two groups were homogenous for general, EPs sonographic and hysteroscopic features. None of the cases of atypia was found. Immunohistochemistry showed that the two groups were similar for ERs and PRs intensity rates in EPs glandular cells despite a trend of ERs percentage expression more than 60% in 2/3 of treated patients versus 1/3 of controls. In stromal EPs components, ERs intensity was high positive in 10 (83,3%) treated cases while it was high positive in 1 control (10%). Percentage of ERs stromal expression showed a different trend between the two groups despite a borderline statistical significance. Our hypothesis is based on a possible double action of hypothyroidism and thyroxine intake: the subclinical TSH increased levels and its possible circadian oscillation could stimulate the endometrial TSHRs (increasing type 2 DIO activity); the circulating levels of exogenous thyroxine could be locally metabolized in active form by type 2 DIO stimulating ERs.

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“…There is also no unequivocality in pathogenic aspects. Some researchers believe EP are estrogen dependent tumors arising in conditions involving hyperestrogenemia [6]. Other authors attribute the formation of EP to an imbalance in the expression of estrogen and progesterone receptors [7].…”

Section: Analysis Of Published Data and Formulation Of Research Taskmentioning

confidence: 99%

Endometrial polyps and micropolyps. Microbial landscape of the uterine cavity and its role in their formation

Татарчук¹,

Herman

2016

Reproductive Endocrinology

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Endometrial polyp is the most common structural abnormality of the mucous membrane of the uterus (endometrium) detected in unexplained infertility. Endometrial micropolyps are a hysteroscopic sign of chronic endometritis, detectable in 60% of women suffering from infertility. Both of the lesions provide an unfavorable environment for the endometrium receptivity and therefore may have common features in their etiopathogenesis.Study objective: to study the composition of microbiota in the vagina, the cervix and the uterine cavity in women of reproductive age diagnosed with endometrial polyps and micropolyps. Study design: the study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Study methods: group I and II were diagnosed by hysteroscopy with histological confirmation, endometrial samples from healthy women were obtained by aspiration biopsy. Test system "Femoflor" was used to study the quantitative composition of vaginal microbiota, bacteriological examination of the cervix and the endometrium was performed by PCR and by cultivating aerobic and anaerobic microorganisms on special growth media.Study results: no statistically significant differences in the quantitative composition of vaginal microbiota have been identified in all study groups, the only changes recorded have been in the number of lactobacilli. The control group reported sufficient content of lactobacilli in 63% of women studied, the group I -39%, the group II -from 23%. The cervical canal was sterile in 29% of women with polyps, 47% of women with micropolyps and 30% of healthy patients. The spectrum of pathogens isolated from the cervical canal was much narrower as opposed to the vagina and had no statistically significant differences between the groups. The frequency of the uterine cavity infection was 83% in women of group I, 73% in group II and 77% in group III. The endometrium of the patients from the control group has been seeded with noticeably more Enterococcus faecalis (43% vs. 11% in group I and 17% in group II). Endometrial samples of women from group I were characterized by significantly higher detection of Candida spp. -21%, and herpes viruses type 1, 2, and 6 -17%. The spectrum of microorganisms isolated from the endometrium of women with micropolyps did not significantly differ from that in the control group. Evaluation of concordance of the vaginal and endometrial biotope in all groups has not shown any significant differences but in Enterococcus faecalis in the I group (0 vs. 11%) and group III (0 to 43%). When comparing cervical and endometrial biotope the only significant difference has been detected in the group of women with endometrial polyps and concerned herpes virus type 6 (0 vs 11%) as well as the high-risk strains of HPV (31% vs. 6%).The limitations of this study: isolated endometrial pathogens were not correlated with the qualitative and quantitative composition of the gastrointestinal microbiot...

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Histopathology and steroid receptors in endometrial polyps of postmenopausal patients under hormone‐replacement therapy

Cited by 29 publications

References 14 publications

Hormone Receptor Expressions and Proliferation Markers in Postmenopausal Endometrial Polyps

Hormone Receptor Expressions and Proliferation Markers in Postmenopausal Endometrial Polyps

Endometrial Polyps in Women Affected by Levothyroxine-Treated Hypothyroidism—Histological Features, Immunohistochemical Findings, and Possible Explanation of Etiopathogenic Mechanism: A Pilot Study

Endometrial polyps and micropolyps. Microbial landscape of the uterine cavity and its role in their formation

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