Singh Meenakshi, Zaino Richard J, Filiaci Virginia J, Leslie Kimberly K
Department of Pathology, The University of Colorado Health Sciences Center, Denver, CO 80262, United States.
Gynecol Oncol. 2007 Aug;106(2):325-33. doi: 10.1016/j.ygyno.2007.03.042. Epub 2007 May 25.
The goal of this study was to explore the relationship between the expression of hormone receptors in metastatic endometrial tumors and clinical response to daily tamoxifen citrate and intermittent weekly medroxyprogesterone acetate.
Patients with measurable recurrent or advanced endometrial cancer were enrolled on a clinical trial, Gynecologic Oncology Group Study 119. A pretreatment tumor biopsy was obtained and subjected to immunohistochemical analyses. Estrogen receptor-alpha (ER-alpha) and progesterone receptor (PR) were assessed on frozen tissues, and PR isoforms A and B were detected on fixed tissues. The receptors were scored using a semi-quantitative HSCORE, with a cut off greater than 75 considered positive.
Of the 60 eligible patients, 45 had evaluable tissues for all receptors. For ER, 40% of the cases were positive; for PR, 45% were positive. The sub-cellular distribution of PRA was exclusively nuclear, and 16% of the tumors demonstrated positive staining. PRB was nuclear and cytoplasmic, with 22% of the tumors staining for nuclear PRB and 36% of the tumors staining for cytoplasmic PRB. ER and PR from frozen tissues and PRA and cytoplasmic PRB from fixed tissues significantly decreased with increasing tumor grade. The co-expression of ER-alpha with PR from the frozen tissues (r=0.68, p<0.001) and PRA (r=0.58, p<0.001) from the fixed tissues was statistically significant. The ER HSCORE was related to both response and overall survival; there was no statistically significant correlation of PR with clinical response in this small number of patients.
ER-alpha measured in metastatic endometrial carcinoma tissue prior to hormonal therapy was statistically significantly related to clinical response to daily tamoxifen and intermittent medroxyprogesterone acetate.
本研究的目的是探讨转移性子宫内膜肿瘤中激素受体的表达与每日服用枸橼酸他莫昔芬和间歇性每周服用醋酸甲羟孕酮的临床反应之间的关系。
可测量的复发性或晚期子宫内膜癌患者参加了一项临床试验，即妇科肿瘤学组研究119。获取预处理肿瘤活检组织并进行免疫组织化学分析。在冷冻组织上评估雌激素受体α（ER-α）和孕激素受体（PR），在固定组织上检测PR亚型A和B。使用半定量HSCORE对受体进行评分，截断值大于75被认为是阳性。
60例符合条件的患者中，45例有可评估所有受体的组织。对于ER，40%的病例为阳性；对于PR，45%为阳性。PRA的亚细胞分布仅在细胞核中，16%的肿瘤显示阳性染色。PRB在细胞核和细胞质中，22%的肿瘤细胞核PRB染色阳性，36%的肿瘤细胞质PRB染色阳性。冷冻组织中的ER和PR以及固定组织中的PRA和细胞质PRB随着肿瘤分级的增加而显著降低。冷冻组织中的ER-α与PR（r = 0.68，p < 0.001）以及固定组织中的PRA（r = 0.58，p < 0.001）的共表达具有统计学意义。ER HSCORE与反应和总生存期相关；在这少数患者中，PR与临床反应无统计学显著相关性。
激素治疗前在转移性子宫内膜癌组织中测得的ER-α与每日服用枸橼酸他莫昔芬和间歇性服用醋酸甲羟孕酮的临床反应具有统计学显著相关性。
