Estrogen and progesterone receptors in endometrial polyps of women exposed and not exposed to tamoxifen and in atrophic endometrium / Receptores de estrógeno e progesterona em pólipos endometriais de usuárias e não usuárias de tamoxifeno e no endométrio atrófico

AUTOR(ES)

Rogério de Barros Ferreira Leão

FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

17/02/2012

RESUMO

Introduction: Tamoxifen has been used for the treatment of strogen receptor-positive breast cancer. The effect of tamoxifen in breast cancer is the it inhibition cancer cell growth by competitive antagonism with strogen for strogen receptor (ER). The mechanism of action of tamoxifen in this receptor varies among different tissues, with antagonist effect (e.g. in breast) ou agonist (e.g. in endometrium). Thus, in menopausal women who use tamoxifen, a higher incidence of endometrial alterations is observed and endometrial polyps are the most common. The pathophysiology of endometrial polyp is still not definitely established but it seems to be related to hormone influence. Objectives: To compare the expression of estrogen receptors (ER) and progesterone receptors (PR) in endometrial polyps of tamoxifen users to atrophic endometrium and endometrial polyps of postmenopausal nonusers of tamoxifen. Material and methods: Among women undergoing surgical hysteroscopy in Hospital da Mulher Prof. Dr. Aristodemo Pinotti - CAISM/UNICAMP, from January 1998 to December 2008, 84 tamoxifen users with benign endometrial polyp were selected. This group was compared to 84 samples of atrophic endometrium and 252 benign polyps of postmenopausal women who were non-users of tamoxifen and no previous history of hormone therapy use. ER/PR expression was assessed by immunohistochemistry study according to the percentage of stained cells, intensity of nuclear color and final score. The expression ER and PR in the glandular epithelium and stroma of polyp tissue from tamoxifen users was compared to atrophic endometrium and polyps from non-users separately, using the Mann-Whitney test corrected by the Bonferroni method, Fisher s exct test or Chi-square test. Results: Polyps of tamoxifen users had a higher expression of ER and PR in the glandular epithelium and stroma, in relation to the atrophic endometrium (p<0.0001). Regarding polyps of women not treated with tamoxifen, users had a higher PR expression in the epithelium (p=0.0014) and stroma (p=0.0056), without any difference in ER expression. Most of polipys expressed ER/PR positives while atrophic endometrium were ER/PR negatives. Conclusions: Polyps frequently exhibit increase in ER expression, independent of the use of tamoxifen. High levels of PR seem to be consistent with agonist effects of the drug.

ASSUNTO(S)

pós-menopausa hormonios esteroides gonadais postmenopause gonadal steroid hormones

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