Negoiţă M, Mihailovici Maria Sultana
Universitatea de Medicină şi Farmacie "Gr. T. Popa", Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2011 Jul-Sep;115(3):834-8.
Tamoxifen is the most commonly prescribed adjuvant therapy for women with breast carcinoma ER+. It has agonist activity on the endometrium and is associated with an increased risk of endometrial carcinoma. The aim of this study was to evaluate the immunohistochemical changes on the histological endometrial modification from the patients treated with tamoxifen.
A group of 20 women selected from 125 patients with breast carcinoma, with adjuvant therapy. The criteria of selection were the histopathological proliferative changes of endometrium from these symptomatic patients. The 20 specimens of endometrium were evaluate immunohistochemycal by estrogen receptor alpha, beta, progesterone receptor, Ki-67 and P53.
The 20 endometrium specimen showed histological proliferative endometrial lessions, including polyps, hyperplasia and carcinoma. Immunohistochemical, benign lessions showned expression of estrogen alpha and beta receptor, low expression Ki-67 and absent expression of P53. These tests were negative in clear cell carcinoma, but were intens positive for Ki-67 and P53. In general, tamoxifen associated endometrial adenocarcinoma were characterized by a lower expression of estrogen receptor alpha, higher expression of progesterone receptor, and more frequent expression of estrogen receptor beta than endometrial spontaneous tumors.
他莫昔芬是雌激素受体阳性乳腺癌女性最常用的辅助治疗药物。它对子宫内膜具有激动剂活性，并与子宫内膜癌风险增加相关。本研究的目的是评估接受他莫昔芬治疗的患者子宫内膜组织学改变的免疫组化变化。
从125例接受辅助治疗的乳腺癌患者中选取20例女性。选择标准是这些有症状患者子宫内膜的组织病理学增殖性改变。对20份子宫内膜标本进行雌激素受体α、β、孕激素受体、Ki-67和P53的免疫组化评估。
20份子宫内膜标本显示组织学上的增殖性子宫内膜病变，包括息肉、增生和癌。免疫组化方面，良性病变显示雌激素α和β受体表达，Ki-67低表达，P53无表达。这些检测在透明细胞癌中为阴性，但Ki-67和P53呈强阳性。总体而言，与他莫昔芬相关的子宫内膜腺癌的特征是雌激素受体α表达较低、孕激素受体表达较高，且与子宫内膜自发肿瘤相比，雌激素受体β表达更频繁。
