Academic Unit of Obstetrics and Gynecology, Birmingham Women's Hospital, Birmingham, B15 2TG, UK.
Acta Obstet Gynecol Scand. 2010 Mar;89(3):393-8. doi: 10.3109/00016340903556006.
We performed immunohistochemical analysis of estrogen (ERalpha) and progesterone receptors (PRA and PRB), phosphatase and tensin homolog (PTEN) and aromatase in endometrial hyperplasia treated with Mirena (levonorgestrel-releasing intrauterine system; LNG-IUS) and explored their prognostic significance. The baseline pre-treatment endometrial hyperplasia of a selected prospective cohort was analyzed [complex (n = 29) and atypical (n = 5)]. Study participants were categorized into those that showed endometrial regression (responders, n = 28) and those that showed non-regression or histological progression to atypia or malignancy (non-responders, n = 6). Immunohistochemical expression was expressed as a histological score (HS). Responders compared to non-responders showed significantly higher HSs for estrogen and progesterone receptors. Absence of estrogen and progesterone receptors predicted non-responder status with likelihood ratios of 9.33 (95% CI 2.19-39.81) and 2.92 (95% CI 1.47-5.79), respectively. Neither PTEN nor aromatase expression were associated with LNG-IUS therapy responsiveness. Responsiveness of endometrial hyperplasia to LNG-IUS therapy may be determined through analysis of baseline estrogen and progesterone receptors, but these exploratory findings require confirmation in a larger dataset.
我们对接受 Mirena（左炔诺孕酮宫内释放系统；LNG-IUS）治疗的子宫内膜增生进行了雌激素（ERalpha）和孕激素受体（PRA 和 PRB）、磷酸酶和张力蛋白同系物（PTEN）和芳香酶的免疫组织化学分析，并探讨了它们的预后意义。对选定的前瞻性队列的基线预处理子宫内膜增生进行了分析[复杂性（n = 29）和非典型性（n = 5）]。研究参与者分为子宫内膜消退的（应答者，n = 28）和非消退或组织学进展为非典型或恶性的（非应答者，n = 6）。免疫组织化学表达表示为组织学评分（HS）。与非应答者相比，应答者的雌激素和孕激素受体的 HS 明显更高。雌激素和孕激素受体的缺失预测非应答者状态的可能性比分别为 9.33（95%CI 2.19-39.81）和 2.92（95%CI 1.47-5.79）。PTEN 和芳香酶的表达均与 LNG-IUS 治疗的反应性无关。LNG-IUS 治疗子宫内膜增生的反应性可能通过分析基线雌激素和孕激素受体来确定，但这些探索性发现需要在更大的数据集得到证实。
