Deligdisch L, Kase N G, Bleiweiss I J
Departments of Pathology and Obstetrics, Gynecology and Reproductive Science, The Mount Sinai School of Medicine, New York, N.Y. 10029, USA.
Gerontology. 2000 Jan-Feb;46(1):17-21. doi: 10.1159/000022128.
Information on steroid receptor content in endometrial tissue of aging women is limited and somewhat controversial. The high incidence of endometrial cancer (EC) and the implication of hormone replacement therapy (HRT) in this group prompted the investigation of steroid receptors and endometrial cancer histology in the elderly.
Review of histologic characteristics correlated with estrogen and progesterone receptors (ER and PR) status in EC in women over 75 years of age in order to determine the prevalence of a more aggressive endometrial neoplasm arising in late postmenopausal atrophic endometrium of elderly patients.
Histologic slides and deeper sections stained immunohistologically for ER/PR from 54 cases of EC in women aged 75-95 years were reviewed. The histologic characteristics and degree of differentiation were correlated with the steroid receptor status, evaluated on a scale of 0-3. Benign endometrial tissue from women of the same group was used as controls.
The 57.4% endometrioid adenocarcinomas were mostly moderately and poorly differentiated. The nonendometrioid carcinomas were anaplastic, papillary, clear cell, squamous cell, mixed müllerian and nongestational choriocarcinoma. The staining intensity for ER/PR decreased with the degree of dedifferentiation being weak or absent in nonendometrioid tumors.
Elderly patients have less differentiated EC displaying histologically nonendometrioid patterns ('alienation') with no differential loss of receptors in cancer. ER/PR are partly preserved in endometrioid tumors and controls. We conclude that differential loss of receptor capacity is not a factor in pathogenesis of this age-related cancer.
关于老年女性子宫内膜组织中类固醇受体含量的信息有限且存在一定争议。子宫内膜癌（EC）的高发病率以及该群体中激素替代疗法（HRT）的影响促使对老年人的类固醇受体和子宫内膜癌组织学进行研究。
回顾75岁以上女性EC中与雌激素和孕激素受体（ER和PR）状态相关的组织学特征，以确定老年患者绝经后晚期萎缩性子宫内膜中发生的侵袭性更强的子宫内膜肿瘤的患病率。
对54例75 - 95岁女性EC的组织学切片及更深层切片进行免疫组织化学ER/PR染色回顾。将组织学特征和分化程度与类固醇受体状态相关联，受体状态按0 - 3级评估。同组女性的良性子宫内膜组织用作对照。
57.4%的子宫内膜样腺癌大多为中分化和低分化。非子宫内膜样癌为间变性、乳头状、透明细胞、鳞状细胞、混合性米勒管癌和非妊娠性绒毛膜癌。ER/PR的染色强度随去分化程度降低，在非子宫内膜样肿瘤中较弱或无染色。
老年患者的EC分化程度较低，组织学表现为非子宫内膜样模式（“异化”），癌症中受体无差异丢失。ER/PR在子宫内膜样肿瘤和对照中部分保留。我们得出结论，受体能力的差异丢失不是这种与年龄相关癌症发病机制的一个因素。
