Konishi I, Koshiyama M, Mandai M, Kuroda H, Yamamoto S, Nanbu K, Komatsu T, Matsushita K, Rao C V, Mori T
Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Sakyo-ku, Japan.
Gynecol Oncol. 1997 May;65(2):273-80. doi: 10.1006/gyno.1997.4656.
Endometrial hyperplasias and carcinomas are well documented to occur in anovulatory women with or without polycystic ovarian syndrome (PCO), which is characterized by hypersecretion of luteinizing hormone (LH). Although overexpression of LH/human chorionic gonadotropin (hCG) receptors has been demonstrated in endometrial carcinomas, whether LH/hCG receptors are also expressed in the endometrial hyperplasias is not known. In this study, the expression of LH/hCG receptors as well as that of progesterone receptors (PR) was analyzed by immunohistochemistry in 20 cases of normal endometria and 24 cases of endometrial hyperplasia and carcinoma (9 simple hyperplasias, 6 complex hyperplasias, 6 atypical hyperplasias, and 3 well-differentiated carcinomas). Fifteen of the 24 patients were 40 years old or younger, presumably anovulatory by BBT chart. Serum levels of LH, follicular stimulating hormone (FSH), prolactin, estradiol, and testosterone were measured by radioimmunoassay. Expression of LH/hCG receptors was detected in 19 of the 21 hyperplasias with a relatively stronger staining intensity in the glandular cells of complex or atypical hyperplasia as compared with normal endometrial glands or simple hyperplasia. In addition, all of the 3 carcinoma specimens showed stronger expression of LH/hCG receptors compared with normal endometria. The expression of LH/hCG receptors was well correlated with the staining for PR. Hormonal assay revealed 3 women to have the typical endocrinological profile of PCO. These findings suggest that the increased expression of LH/hCG receptors is a feature of endometrial hyperplasia and carcinoma developing in younger anovulatory women including those with PCO.
子宫内膜增生和癌在有无多囊卵巢综合征（PCO）的无排卵女性中均有充分记录，多囊卵巢综合征的特征是黄体生成素（LH）分泌过多。尽管已证实在子宫内膜癌中存在LH/人绒毛膜促性腺激素（hCG）受体的过表达，但LH/hCG受体是否也在子宫内膜增生中表达尚不清楚。在本研究中，通过免疫组织化学分析了20例正常子宫内膜以及24例子宫内膜增生和癌（9例单纯性增生、6例复杂性增生、6例不典型增生和3例高分化癌）中LH/hCG受体以及孕激素受体（PR）的表达。24例患者中有15例年龄在40岁及以下，根据基础体温图推测为无排卵。通过放射免疫测定法检测血清中LH、卵泡刺激素（FSH）、催乳素、雌二醇和睾酮的水平。在21例增生中，有19例检测到LH/hCG受体表达，与正常子宫内膜腺体或单纯性增生相比，复杂性或不典型增生的腺细胞中染色强度相对较强。此外，与正常子宫内膜相比，所有3例癌标本中LH/hCG受体的表达均更强。LH/hCG受体的表达与PR染色密切相关。激素测定显示3名女性具有典型的PCO内分泌特征。这些发现表明，LH/hCG受体表达增加是年轻无排卵女性（包括患有PCO的女性）发生子宫内膜增生和癌的一个特征。
