Steroid Receptor Expression in Endometria from Women Treated with Tamoxifen

Kommoss, Friedrich; Karck, U.; Prömpeler, H. J.; Pfisterer, Jacobus; Kirkpatrick, Charles James

doi:10.1006/gyno.1998.5087

Cited by 17 publications

(6 citation statements)

References 17 publications

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“…The expression of both ER and PR was found to be consistently positive in endometria from women treated with tamoxifen (Cano and Hermenegildo, 2000). This positivity was reported to be even higher than that found in a control group of premenopausal women (Kommoss et al 1998). Tamoxifen also mimicked estradiol treatment in upregulating ER, c-fos, and glyceraldehyde phosphate dehydogenase mRNAs, together with other estrogen-induced genes (Rivera-Gonzalez et al 1998; Robertson et al 1998).…”

Section: Uterine Corpuscontrasting

confidence: 55%

Tumorigenic Effects of Tamoxifen on the Female Genital Tract

Nasu

Takai

Nishida

et al. 2008

Clinical medicine. Pathology

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Tamoxifen is widely used for endocrine treatment and breast cancer prevention. It acts as both an estrogen antagonist in breast tissue and an estrogen agonist in the female lower genital tract. Tamoxifen causes severe gynecologic side effects, such as endometrial cancer. This review focuses on the effects of prolonged tamoxifen treatment on the human female genital tract and considers its tumorigenicity in the gynecologic organs through clinical data analysis. Tamoxifen is associated with an increased incidence of benign endometrial lesions such as polyps and hyperplasia and a two-to four-fold increased risk of endometrial cancer in postmenopausal patients. Moreover, the incidence of functional ovarian cysts is signifi cantly high in premenopausal tamoxifen users. To prevent tamoxifen from having severe side effects in gynecologic organs, frequent gynecological examination should be performed for both premenopausal and postmenopausal patients with breast cancer who are treated with this drug.

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Section: Uterine Corpuscontrasting

confidence: 55%

Tumorigenic Effects of Tamoxifen on the Female Genital Tract

Nasu

Takai

Nishida

et al. 2008

Clinical medicine. Pathology

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“…Moreover, tamoxifen may affect the transcriptional activity of ERa and regulate the expression of ERa in endometrium, thereby promoting estrogen-mediated cell growth. [28][29][30] In the nonestrogen pathway, tamoxifen may promote endometrial proliferation directly both in vitro 31 and in vivo. 32 Multiple proliferation markers, such as Rbretinoblastoma family proteins, cyclin protein, and cyclindependent kinase 2, were observed to increase after tamoxifen injection in mice.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Tamoxifen on Thin Endometrium in Patients Undergoing Frozen—Thawed Embryo Transfer

Jiang

Xia

et al. 2018

Reprod. Sci.

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Tamoxifen has played a vital role in endocrine therapy for the treatment of estrogen receptor-positive breast cancer. We examined the effect of tamoxifen in patients with a thin endometrium in frozen-thawed embryo transfer (FET) cycles and compared the improvement in endometrial thickness (EMT) and pregnancy outcomes stratified by different etiologies of thin endometrium. A total of 226 women were recruited for a new tamoxifen protocol; all had an EMT of less than 7.5 mm in previous cycles, including natural cycle (NC), hormone replacement treatment (HRT), and ovulation induction (OI) cycles. Compared with previous cycles, tamoxifen cycles showed a significantly increased EMT (from 6.11 ± 0.98 mm to 7.87 ± 1.48 mm in the NC group, from 6.24 ± 1.01 mm to 8.22 ± 1.67 mm in the HRT group, and from 6.34 ± 1.03 mm to 8.05 ± 1.58 mm in the OI group; all P < .001). Patients were further divided into 3 groups based on the causes of their thin endometrium: (1) history of intrauterine adhesion (n = 34), (2) history of uterine curettage (n = 141), and (3) polycystic ovary syndrome (PCOS; n = 51). Patients with PCOS obtained the thickest EMT (9.31 ± 1.55 mm), the lowest cycle cancellation rate (11.76%), and the highest rate of clinical pregnancy (60%) and live birth (55.56%) per transfer ( P < .001). Multivariable regression analysis showed that EMT was related to live birth (odds ratio: 1.487; 95% confidence interval: 1.172-1.887). A tamoxifen protocol improves EMT in patients after NC, HRT, and OI cycles during FET. Patients with PCOS show the most benefit from tamoxifen and achieve better pregnancy outcomes.

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“…The consistent finding of ER and PR expression in the endometria of post-menopausal women receiving Tam further supports the suspected estrogenic effect exerted by Tam on endometrial cells. Progestational therapy could be beneficial in the prevention of Tam-induced abnormal endometrial proliferations [20] . …”

Section: Overviewmentioning

confidence: 99%

Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age

et al. 2013

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IntroductionEndometrial hyperplasia has a high risk for malignant transformation and relapses; existing mini-invasive treatments may lead to irrevocable endometrium destruction. The aims were to analyze receptor systems in endometrial hyperplasia, to evaluate the capabilities of ultrasonography, sonoelastography for diagnosis and treatment control, and to develop treatment algorithm.Materials and methodsWe included 313 women (20–45 years), assessed into the following: group 1 (n = 112) with glandular cystic hyperplasia, group 2 (n = 98) endometrial polyps, and group 3 (n = 103) atypical hyperplasia; and 82 controls who have undergone hysteroscopy before in vitro fertilization in tubal origin infertility were also included. Patients underwent clinical examination, transvaginal ultrasound, immunohistochemical study, and hormonal therapy/hysteroresectoscopy.ResultsIn patients with glandular hyperplasia, we registered increase of endometrium estrogen receptors (75.6% in the epithelium and 30.9% in the stroma; in controls, 43.3% and 29.6%, respectively); in polyps, there was a significant estrogen receptor increase in the stroma (48.2% vs 29.6% in controls), and in atypical hyperplasia, progesterone receptors significantly increased in the stroma. Ki-67 increased (40% to 50%) in the epithelium without changes in the stroma. Ultrasound has a sensitivity of 96% and a specificity of 85% for early detection of endometrial pathology and prediction outcome of intervention, and sonoelastography has a sensitivity of 91% and a specificity of 83% for polyp diagnosis. Personalized treatment was effective in 88.8%, relapse was diagnosed in 11.2% after 6 months, and conservative treatment of atypical hyperplasia was effective in 45%: in 25.8%, ablative hysteroresectoscopy was performed, while in 22.6% with comorbidities, hystero/oophorectomies were performed.ConclusionsThe evaluation of receptor status with ultrasound data in patients with endometrial hyperplasia allows for a clear definition of the treatment policy, avoidance of relapse, treatment optimization, and observation of such patients.

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Steroid Receptor Expression in Endometria from Women Treated with Tamoxifen

Cited by 17 publications

References 17 publications

Tumorigenic Effects of Tamoxifen on the Female Genital Tract

Tumorigenic Effects of Tamoxifen on the Female Genital Tract

The Effect of Tamoxifen on Thin Endometrium in Patients Undergoing Frozen—Thawed Embryo Transfer

Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age

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