Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps and adjacent endometrium in postmenopausal women

Almeida, E.C.; Nogueira, Antônio Alberto; Reis, Francisco José Candido dos; Ramalho, Leandra Náira Zambelli; Zucoloto, Sérgio

doi:10.1016/j.maturitas.2004.02.009

Cited by 73 publications

(54 citation statements)

References 17 publications

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“…Sant' Ana de Almeida ve ark. 13 tarafından yapılan bir immunhistokimyasal çalışmada, polibe ait glandüler stromada ve polibe komşu endometriuma ait glandü-ler epitelde artmış östrojen ve progesteron reseptör ekspresyonu saptanmıştır. Polip stromasındaki östro-jen reseptör ekspesyonu, polibe komşu endometriyal stromadaki ekspresyona oranla daha kuvvetli bulunmuştur.…”

Section: Discussionunclassified

The Relationship Between Endometrial Polyps, Obesity, the Incidence of Diabetes and Hypertension in Women Who Admitted with Abnormal Uterin Bleeding in Reproductive Ages

Yücel¹,

Seçkin²,

Özköse³

et al. 2017

Kafkas J Med Sci

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Aim: To investigate whether endometrial polyps are associated with obesity and incidence of diabetes mellitus or hypertension in women who admitted with abnormal uterin bleeding in reproductive ages. Material and Method (30,1±2,94), kontrol grubu (28,2±1,92) ile karşılaştırıldığında istatistiksel olarak anlamlı yüksekti (p <0,001). Diyabet ve hipertansiyon sıklığı yine endometrial polip grubunda (%8,33 ve %6,67) kontrol grubuna oranla (%3,44 ve %2,19)

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Section: Discussionunclassified

The Relationship Between Endometrial Polyps, Obesity, the Incidence of Diabetes and Hypertension in Women Who Admitted with Abnormal Uterin Bleeding in Reproductive Ages

Yücel¹,

Seçkin²,

Özköse³

et al. 2017

Kafkas J Med Sci

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“…RCTs should be conducted to delineate the optimal surgical approach and identify the best technologies in terms of feasibility, acceptability and effectiveness to treat common uterine pathologies, such as uterine polyps, in an outpatient setting. 4. RCTs designed to evaluate approaches to minimising pain and enhancing both recovery and acceptability of outpatient, ambulatory interventions.…”

Section: Implications For Health Carementioning

confidence: 99%

A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding

Clark

Middleton

Cooper

et al. 2015

Health Technol Assess

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BackgroundUterine polyps cause abnormal bleeding in women and conventional practice is to remove them in hospital under general anaesthetic. Advances in technology make it possible to perform polypectomy in an outpatient setting, yet evidence of effectiveness is limited.ObjectivesTo test the hypothesis that in women with abnormal uterine bleeding (AUB) associated with benign uterine polyp(s), outpatient polyp treatment achieved as good, or no more than 25% worse, alleviation of bleeding symptoms at 6 months compared with standard inpatient treatment. The hypothesis that response to uterine polyp treatment differed according to the pattern of AUB, menopausal status and longer-term follow-up was tested. The cost-effectiveness and acceptability of outpatient polypectomy was examined.DesignA multicentre, non-inferiority, randomised controlled trial, incorporating a cost-effectiveness analysis and supplemented by a parallel patient preference study. Patient acceptability was evaluated by interview in a qualitative study.SettingOutpatient hysteroscopy clinics and inpatient gynaecology departments within UK NHS hospitals.ParticipantsWomen with AUB – defined as heavy menstrual bleeding (formerly known as menorrhagia) (HMB), intermenstrual bleeding or postmenopausal bleeding – and hysteroscopically diagnosed uterine polyps.InterventionsWe randomly assigned 507 women, using a minimisation algorithm, to outpatient polypectomy compared with conventional inpatient polypectomy as a day case in hospital under general anaesthesia.Main outcome measuresThe primary outcome was successful treatment at 6 months, determined by the woman’s assessment of her bleeding. Secondary outcomes included quality of life, procedure feasibility, acceptability and cost per quality-adjusted life-year (QALY) gained.ResultsAt 6 months, 73% (166/228) of women who underwent outpatient polypectomy were successfully treated compared with 80% (168/211) following inpatient polypectomy [relative risk (RR) 0.91, 95% confidence interval (CI) 0.82 to 1.02]. The lower end of the CIs showed that outpatient polypectomy was at most 18% worse, in relative terms, than inpatient treatment, within the 25% margin of non-inferiority set at the outset of the study. By 1 and 2 years the corresponding proportions were similar producing RRs close to unity. There was no evidence that the treatment effect differed according to any of the predefined subgroups when treatments by variable interaction parameters were examined. Failure to completely remove polyps was higher (19% vs. 7%; RR 2.5, 95% CI 1.5 to 4.1) with outpatient polypectomy. Procedure acceptability was reduced with outpatient compared with inpatient polyp treatment (83% vs. 92%; RR 0.90, 95% CI 0.84 to 0.97). There were no significant differences in quality of life. The incremental cost-effectiveness ratios at 6 and 12 months for inpatient treatment were £1,099,167 and £668,800 per additional QALY, respectively.ConclusionsWhen treating women with AUB associated with uterine polyps, outpatient polypectomy was non-inferior to inpatient polypectomy at 6 and 12 months, and relatively cost-effective. However, patients need to be aware that failure to remove a polyp is more likely with outpatient polypectomy and procedure acceptability lower.Trial registrationCurrent Controlled Trials ISRCTN 65868569.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 61. See the NIHR Journals Library website for further project information.

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“…Previous studies demonstrated a higher ER expression in the epithelium and stroma of the endometrial polyps from menopausal patients Differences in estrogen and progesterone receptor expression in endometrial polyps and atrophic endometrium of postmenopausal women with and without exposure to tamoxifen in comparison to the adjacent atrophic endometrium (17)(18)(19). With regard to the expression of PR, previous studies have demonstrated a higher expression in the epithelium and not the stroma of the polyp, compared to the adjacent atrophic endometrium (17)(18)(19)(20). This finding suggests that endometrial polyps have a higher sensitivity to estrogen and progesterone and may develop even in the presence of low serum hormone concentrations (19).…”

Section: Introductionmentioning

confidence: 98%

“…With regard to the expression of PR, previous studies have demonstrated a higher expression in the epithelium and not the stroma of the polyp, compared to the adjacent atrophic endometrium (17)(18)(19)(20). This finding suggests that endometrial polyps have a higher sensitivity to estrogen and progesterone and may develop even in the presence of low serum hormone concentrations (19). Previous studies comparing polyps from tamoxifen users to those from non-users have reported lower ER expression and increased PR expression in tamoxifen users, demonstrating an agonist effect of tamoxifen on the endometrium.…”

Section: Introductionmentioning

confidence: 99%

Differences in estrogen and progesterone receptor expression in endometrial polyps and atrophic endometrium of postmenopausal women with and without exposure to tamoxifen

Leao

Andrade

Vassalo

et al. 2013

Molecular and Clinical Oncology

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Abstract.Postmenopausal women who use tamoxifen present with an increased incidence of endometrial alterations, such as polyps and hyperplasia, in addition to a higher risk of malignant endometrial neoplasms. Among these endometrial changes, polyps are the most common, with a pathogenesis associated with hormonal influence. The objective of this study was to compare the expression of estrogen receptors (ERs) and progesterone receptors (PRs) in endometrial polyps from tamoxifen users with that in endometrial polyps and the atrophic endometrium of postmenopausal tamoxifen non-users. Among women undergoing surgical hysteroscopy, 84 tamoxifen users with benign endometrial polyps were selected. This group was compared to 84 samples of atrophic endometrium and to 252 benign polyps from postmenopausal women who were not treated with tamoxifen. The expression of ER̸PR was assessed by immunohistochemical analysis, according to the percentage of stained cells, intensity of nuclear staining and final score. The polyps from tamoxifen users exhibited a higher expression of ER and PR in the glandular epithelium and stroma compared to the atrophic endometrium (P<0.0001). Compared to the polyps from women not treated with tamoxifen, tamoxifen users exhibited a higher PR expression in the epithelium (P=0.0014) and stroma (P=0.0056), with no difference in the expression of ER. In conclusion, endometrial polyps frequently exhibit an increase in ER expression, regardless of tamoxifen use. High levels of PR expression appear to be consistent with the estrogen agonist effects of tamoxifen.

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Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps and adjacent endometrium in postmenopausal women

Cited by 73 publications

References 17 publications

The Relationship Between Endometrial Polyps, Obesity, the Incidence of Diabetes and Hypertension in Women Who Admitted with Abnormal Uterin Bleeding in Reproductive Ages

The Relationship Between Endometrial Polyps, Obesity, the Incidence of Diabetes and Hypertension in Women Who Admitted with Abnormal Uterin Bleeding in Reproductive Ages

A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding

Differences in estrogen and progesterone receptor expression in endometrial polyps and atrophic endometrium of postmenopausal women with and without exposure to tamoxifen

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