Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Republic of Korea.
Virchows Arch. 2018 Jul;473(1):61-69. doi: 10.1007/s00428-018-2358-5. Epub 2018 Jun 4.
To evaluate the immunohistochemical (IHC) expression of hormone receptors and analyze the prognostic implication of these receptors in patients with endometrial stromal sarcoma (ESS). Fifty-one patients with ESS whose paraffin blocks and pathologic slides, which were obtained after hysterectomy, were available and included in this study. Clinicopathologic data were gathered from patients' medical records, and IHC staining of hormone receptors was performed using tissue microarrays. Estrogen receptor (ER)-alpha was expressed in 37 patients (72.5%), and strong immunoreactivity was observed in 27 patients (52.9%). However, ER-beta expression was observed in only two patients (3.9%). Progesterone receptor (PR) expression was identified in 36 patients (70.6%), and strong immunoreactivity was found in 26 patients (51%). Androgen receptor (AR) expression was observed in 30 patients (58.8%), and strong immunoreactivity was noted in 14 patients (27.5%). Gonadotropin-releasing hormone receptor (GnRH-R) expression was observed in 49 patients (96.1%), but no patient exhibited strong immunoreactivity. All patients expressed CYP19A1, and 43 patients (84.3%) had strong immunoreactivity. ER-alpha, PR, and AR positivity was associated with significantly better overall survival (OS). No patient with AR positivity died of ESS. When the patients were categorized according to ER-alpha, PR, and AR immunoreactivity, triple-positive ESS had the best OS, and triple-negative ESS was linked to the worst OS. Expression of hormone receptors was associated with favorable survival outcome in ESS. Hormone receptors that showed strong expression deserve further evaluation to clarify their importance as a therapeutic target and predictor of treatment response.
评估激素受体的免疫组织化学（IHC）表达，并分析这些受体在子宫内膜间质肉瘤（ESS）患者中的预后意义。本研究纳入了 51 例 ESS 患者，这些患者均接受了子宫切除术，并提供了石蜡块和病理切片。从患者的病历中收集临床病理数据，并使用组织微阵列进行激素受体的 IHC 染色。37 例患者（72.5%）表达雌激素受体（ER）-α，其中 27 例（52.9%）表现出强免疫反应性。然而，仅在 2 例患者（3.9%）中观察到 ER-β表达。孕激素受体（PR）在 36 例患者（70.6%）中表达，其中 26 例（51%）表现出强免疫反应性。雄激素受体（AR）在 30 例患者（58.8%）中表达，其中 14 例（27.5%）表现出强免疫反应性。49 例患者（96.1%）表达促性腺激素释放激素受体（GnRH-R），但无患者表现出强免疫反应性。所有患者均表达 CYP19A1，其中 43 例（84.3%）表现出强免疫反应性。ER-α、PR 和 AR 阳性与总生存（OS）显著相关。无 AR 阳性患者死于 ESS。根据 ER-α、PR 和 AR 免疫反应性对患者进行分类，三阳性 ESS 的 OS 最佳，三阴性 ESS 的 OS 最差。激素受体的表达与 ESS 的生存结果相关。表现出强表达的激素受体值得进一步评估，以明确其作为治疗靶点和治疗反应预测因子的重要性。
