Sivridis E, Giatromanolaki A
Department of Pathology, Democritus University of Thrace, Alexandroupolis 68100, Greece.
J Clin Pathol. 2004 Aug;57(8):840-4. doi: 10.1136/jcp.2003.014399.
To investigate proliferation in disease free postmenopausal endometrium and that harbouring endometrial adenocarcinoma-is there a dynamic, yet lurking, potential for atrophic endometrium to give rise to endometrial adenocarcinoma?
MATERIAL/METHODS: The study comprised 84 disease free endometria from asymptomatic postmenopausal women who had undergone hysterectomy for prolapse, and 50 endometrioid cell type endometrial adenocarcinomas with adjacent uninvolved postmenopausal endometrium. The non-neoplastic tissues were separated histologically into active, inactive, and mixed forms, although only the first two categories were studied immunohistochemically for oestrogen and progesterone receptors (ERs, PRs), epidermal growth factor receptor (EGFR), Ki-67, and angiogenic activity.
All postmenopausal endometria were atrophic, but only 42 were inactive; of the remaining samples, 22 were weakly proliferative and 20 were mixed active and inactive. In contrast, the non-neoplastic component of 43 of the 50 endometrial adenocarcinomas examined was of the active form; four specimens were of the pure and 39 of the mixed form. Interestingly, high ER and PR expression was seen in active and inactive endometria, but only the former were EGFR positive and had high proliferative (Ki-67) and angiogenic activity. A similar trend was also shown by the non-neoplastic atrophic endometrium adjacent to endometrial adenocarcinoma.
At least half of the disease free postmenopausal atrophic endometria show a weak proliferative pattern, either diffuse or focal, probably as a response to continuous low level oestrogenic stimulation. These tissues have a latent, although very small, carcinogenic potential, as demonstrated by the immunohistochemical profile and their frequent association with adjacent endometrial adenocarcinoma.
研究绝经后无病子宫内膜以及患有子宫内膜腺癌的子宫内膜的增殖情况——萎缩性子宫内膜是否存在动态但潜在的发展为子宫内膜腺癌的可能性？
材料/方法：本研究包括84例因子宫脱垂接受子宫切除术的无症状绝经后妇女的无病子宫内膜，以及50例子宫内膜样细胞型子宫内膜腺癌及其相邻未受累的绝经后子宫内膜。非肿瘤组织在组织学上分为活跃型、不活跃型和混合型，不过仅对前两类进行雌激素和孕激素受体（ERs、PRs）、表皮生长因子受体（EGFR）、Ki-67以及血管生成活性的免疫组织化学研究。
所有绝经后子宫内膜均为萎缩性，但只有42例为不活跃型；其余样本中，22例轻度增殖，20例为活跃与不活跃混合型。相比之下，所检查的50例子宫内膜腺癌中，43例的非肿瘤成分呈活跃型；4例为纯活跃型，39例为混合活跃型。有趣的是，活跃型和不活跃型子宫内膜中均可见高ER和PR表达，但只有前者EGFR呈阳性且具有高增殖性（Ki-67）和血管生成活性。与子宫内膜腺癌相邻的非肿瘤性萎缩子宫内膜也呈现类似趋势。
至少一半的绝经后无病萎缩性子宫内膜表现出轻度增殖模式，可为弥漫性或局灶性，这可能是对持续低水平雌激素刺激的反应。这些组织具有潜在的致癌可能性，尽管非常小，免疫组织化学特征及其与相邻子宫内膜腺癌的频繁关联证明了这一点。
