Oestrogen and Progesterone Receptor Concentrations in Leiomyoma and Normal Myometrium

Sadan, Oscar; Iddekinge, B. Van; Gelderen, C. J. Van; Savage, Nerina; Becker, P J; Walt, L. A. van der; Robinson, M. G.

doi:10.1177/000456328702400304

Cited by 67 publications

(28 citation statements)

References 18 publications

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“…These tumors do not only morphologically resemble uterine leiomyomas, but they also are positive for ER, which is similar to uterine leiomyomas (21,22) and dissimilar to GISTs, which are ER-negative according to our results. Therefore, ER immunostaining is a valuable aid to separate the uterine type leiomyomas from GISTs.…”

Section: Discussionsupporting

confidence: 70%

Immunohistochemical Spectrum of GISTs at Different Sites and Their Differential Diagnosis with a Reference to CD117 (KIT)

2000

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Gastrointestinal (GI) stromal tumor (GIST) is the designation for the major subset of GI mesenchymal tumors and encompasses most tumors previously classified as GI smooth muscle tumors. Although GISTs typically express CD117 (KIT), often express CD34, and sometimes express ␣-smooth muscle actin (SMA), the relative frequency of these markers has not been characterized in large series of GISTs of different sites, and the CD117 expression has not been fully characterized in intra-abdominal tumors. In this study, we immunohistochemically analyzed 292 GISTs throughout the GI tract, including omentum and mesentery, and compared the immunoreactivities with 211 other tumors that may enter in the differential diagnosis. GISTs were defined in this study as CD117-positive primary spindled or epithelioid mesenchymal tumors of the GI tract, omentum, or mesentery. The CD34 positivity of GISTs varied from 47% in small bowel to 96 to 100% in rectum and esophagus, whereas SMA expression showed the opposite patterns and was most frequent in the GISTs of small bowel (47%) and rarest in the GISTs of rectum and esophagus (10 -13%). Desmin was seen only occasionally. S100 positivity was rare but was seen most frequently in small intestinal GISTs (15%). True leiomyomas from esophagus, muscularis mucosae of colorectum, and pericolic leiomyomas similar to uterine leiomyomas were negative for CD117 and CD34 and positive for SMA and desmin (46 of 46). Inflammatory fibroid polyps of stomach and small intestine were negative for CD117 but were often positive for CD34 (6 of 8) and variable for SMA (3 of 8). Inflammatory myofibroblastic tumors involving gastric or colonic wall were negative for CD117 but some showed CD117-positive endothelia. GI schwannomas were all negative for CD117 and positive for S100 protein (11 of 11). Extremely focal CD117 positivity was seen in the neoplastic cells of some retroperitoneal leiomyosarcomas and liposarcomas. Among other CD117-positive tumors were intestinal metastatic melanomas (8 of 11) and extraskeletal Ewing's sarcomas (5 of 11), two of which were abdominal. In conclusion, strong CD117 expression defines most primary GI mesenchymal tumors as GISTs, which show different patterns for CD34 and SMA in various parts of the GI tract. Some unrelated CD117-positive tumors (melanomas, Ewing's sarcomas) should not be confused with GISTs.

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Section: Discussionsupporting

confidence: 70%

Immunohistochemical Spectrum of GISTs at Different Sites and Their Differential Diagnosis with a Reference to CD117 (KIT)

2000

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“…Strong evidence exists that the effect of estrogen is to increase the levels of both ER and PR in the myometrium, whereas the effect of progesterone is to decrease the level of the ER (Hsueh et al 1975;Katzenellenbogen 1980;Thi et al 1975). These conclusions are consistent with the sequential presentation of these two hormones during the menstrual cycle and the predominant observations that in the myometrium both ER and PR rise during the follicular (proliferative) phase and then fall during the luteal (secretory) phase of the menstrual cycle (Adams et al 1993;Buchi and Keller 1983;Englund et al 1998;Hsueh et al 1975;Janne et al 1975;Kawaguchi et al 1991;Lessl et al 1997;Marugo et al 1989;Rein et al 1990c;Sadan et al 1987;SchmidtGollwitzer et al 1979;Soules and McCarty 1982;Thi et al 1975). Because PR levels also fall during the luteal phase, some feel that progesterone may downregulate its own receptor (Englund et al 1998); this conclusion was also reached by Thi et al (1975), who demonstrated a fall in PR in the myometrium of ovariectomized guinea pigs when given progesterone (Thi et al 1975).…”

Section: Laboratory Studiessupporting

confidence: 75%

“…Interestingly, in one study (Marugo et al 1989) the ER and PR levels were significantly higher in submucous than subserosal leiomyomas, leading the authors to speculate about different etiologies and types of leiomyomas. The receptor concentrations were independent of the size of the tumor in one report (Sadan et al 1987). Another investigation found marked variation in ER and PR levels in different tumors from the same subject (Englund et al 1998); such heterogeneity may relate to the degree of hyalinization and involution of individual tumors.…”

Section: Laboratory Studiesmentioning

confidence: 87%

“…In addition, Sadan et al found the ER and PR to be elevated in fibroids during all phases of the menstrual cycle when compared with matched myometria (Sadan et al 1987). Interestingly, in one study (Marugo et al 1989) the ER and PR levels were significantly higher in submucous than subserosal leiomyomas, leading the authors to speculate about different etiologies and types of leiomyomas.…”

Section: Laboratory Studiesmentioning

confidence: 98%

“…In the majority of the studies reviewed, the concentrations of both the ERs and PRs were greater in leiomyomata than the myometrium Brandon et al 1993Brandon et al , 1995Buchi and Keller 1983;Eiletz et al 1980;Englund et al 1998;Kawaguchi et al 1991;Lessl et al 1997;Marugo et al 1989;Nisolle et al 1999;Otsuka et al 1989;Pollow et al 1978a;Puukka et al 1976;Rein et al 1990c;Sadan et al 1987;Soules and McCarty 1982;Tamaya et al 1979Tamaya et al , 1985Vij et al 1990;Viville et al 1997;Vollenhoven et al 1994;Wilson et al 1980). In addition, Sadan et al found the ER and PR to be elevated in fibroids during all phases of the menstrual cycle when compared with matched myometria (Sadan et al 1987).…”

Section: Laboratory Studiesmentioning

confidence: 98%

See 2 more Smart Citations

Etiology and pathogenesis of uterine leiomyomas: a review.

Flake

Andersen

Dixon

2003

Environ Health Perspect

496

392

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Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor-β 3, basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review.

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Histologic, morphometric, and immunocytochemical analysis of myometrial development in rats and mice: I. Normal development

Brody¹,

Cunha²

1989

Am. J. Anat.

140

115

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Myometrial development from the prenatal to adult period was examined in rats and mice 1) by histologic and immunocytochemical methods with anti-actin, -vimentin, and -laminin to assess cytodifferentiation of smooth muscle and fibroblastic cells; and 2) by morphometric procedures to assess quantitatively the expression of cellular orientation in the emerging inner circular myometrial layer. Uterine mesenchymal cells initially were uniformly vimentin-positive, undifferentiated, and randomly oriented during the late fetal period. By the early neonatal period, three mesenchymal layers became recognizable histologically, the middle one of which (prospective circular myometrium) developed distinct circular orientation and differentiated into a layer composed of actin-positive smooth muscle cells. The cells of the inner mesenchymal layer initially exhibited radial orientation. By 10 days postpartum, the outer longitudinal mesenchymal layer differentiated into bundles of smooth muscle cells representing the longitudinal myometrium. The inner mesenchymal layer remained vimentin-positive and differentiated into the randomly ordered endometrial stroma. The cells of the middle and outer mesenchymal layers that were destined to form myometrium initially expressed vimentin throughout and then coexpressed vimentin and actin, but with time vimentin staining disappeared in the maturing smooth muscle cells as they expressed actin.

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Oestrogen and Progesterone Receptor Concentrations in Leiomyoma and Normal Myometrium

Cited by 67 publications

References 18 publications

Immunohistochemical Spectrum of GISTs at Different Sites and Their Differential Diagnosis with a Reference to CD117 (KIT)

Immunohistochemical Spectrum of GISTs at Different Sites and Their Differential Diagnosis with a Reference to CD117 (KIT)

Etiology and pathogenesis of uterine leiomyomas: a review.

Histologic, morphometric, and immunocytochemical analysis of myometrial development in rats and mice: I. Normal development

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