Abu Shahin Nisreen, Aladily Tariq, Abu Alhaj Nezeen, Al-Khader Ali, Alqaqa Shefa, Aljaberi Reyad, Amer Lama, Elshebli Sanad
Department of Pathology, Faculty of Medicine, University of Jordan, Amman, Jordan.
Department of Pathology, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan.
Oman Med J. 2021 Mar 31;36(2):e245. doi: 10.5001/omj.2021.53. eCollection 2021 Mar.
Endometrial carcinomas (EC) are the most common gynecological malignancies and are conventionally divided into type I and type II due to diagnostic and prognostic considerations. Female hormone expression in EC is extensively studied; however, data about androgen receptor (AR) expression in EC are sparse. We aimed to study AR expression in different types of EC at our institute and whether it had an impact on patient outcomes.
A retrospective analysis of EC cases diagnosed and treated from 2010-2019. AR immunohistochemical expression was tested in 52 EC cases (type I = 40; type II = 12). Histological typing was verified according to conventional diagnostic criteria. Only primary EC were included without neoadjuvant therapy. Histologic score was calculated as: stain intensity (graded 0-3) × positive cells percentage (graded 0-4). Level of expression was scored from 0 to 12.
The mean age of the selected patients was 60.3 years (range = 31-88 ± 12.6). Recurrence was detected in 11 (21.2%) patients. The outcome was 40 patients were alive without disease, eight alive with disease, three dead of disease, and one dead of other causes. About 62.5% of type I-EC and 25.0% of type II-EC were AR positive. AR expression was analyzed against different clinicopathological parameters including: type ( 0.005), histotype ( 0.044); grade ( 0.035); age group ( 0.207); menopause ( 0.086); estrogen receptor (ER) expression ( 0.284); atypical complex hyperplasia ( 0.594); tumor stage ( 0.994); tumor recurrence ( 0.530); node status ( 0.110); and outcome ( 0.202).
AR expression was higher in type I EC, endometrial endometrioid carcinoma histotype, and with a lower grade. AR expression was not significantly correlated with age, stage, ER, atypical hyperplasia, recurrence, node status, or outcome. Results agree with recent literature that AR expression is associated with better-differentiated EC and may be a potential hormonal therapeutic tool.
子宫内膜癌（EC）是最常见的妇科恶性肿瘤，出于诊断和预后考虑，传统上分为I型和II型。EC中女性激素表达已得到广泛研究；然而，关于EC中雄激素受体（AR）表达的数据却很稀少。我们旨在研究我院不同类型EC中AR的表达情况及其是否对患者预后产生影响。
对2010年至2019年诊断和治疗的EC病例进行回顾性分析。对52例EC病例（I型=40例；II型=12例）进行AR免疫组化表达检测。根据传统诊断标准进行组织学分型验证。仅纳入未接受新辅助治疗的原发性EC。组织学评分计算为：染色强度（0-3级）×阳性细胞百分比（0-4级）。表达水平评分为0至12分。
所选患者的平均年龄为60.3岁（范围=31-88±12.6）。11例（21.2%）患者检测到复发。结果为40例患者无病存活，8例带瘤存活，3例死于疾病，1例死于其他原因。约62.5%的I型EC和25.0%的II型EC为AR阳性。针对不同临床病理参数分析AR表达，包括：类型（0.005）、组织学类型（0.044）、分级（0.035）、年龄组（0.207）、绝经状态（0.086）、雌激素受体（ER）表达（0.284）、非典型复杂性增生（0.594）、肿瘤分期（0.994）、肿瘤复发（0.530）、淋巴结状态（0.110）和预后（0.202）。
I型EC、子宫内膜样癌组织学类型且分级较低的患者中AR表达较高。AR表达与年龄、分期、ER、非典型增生、复发、淋巴结状态或预后无显著相关性。结果与近期文献一致，即AR表达与高分化EC相关，可能是一种潜在的激素治疗工具。
