Oestrogen and Progesterone Receptor Concentrations in Leiomyoma and Normal Myometrium

Abstract

SUMMARY. The content of cytoplasmic 17~oestradiol and progesterone receptors in human uterine leiomyoma and normal myometrium in the Negroid population was determined. Eighteen women of reproductive age. at various stages of the menstrual cycle. were included in the study. The serum oestrogen and progesterone concentrations were also measured. This is the first report in the literature in which oestrogen and progesterone receptors in leiomyoma are significantly higher than in normal myometrium (P=().()002). The steroid dependence of the growth of leiomyomas may be related to the steroid receptor level. The presence of persistently high concentrations of oestrogen and progesterone receptors in leiomyoma should be helpful in the treatment of this benign tumour.Leiomyoma of the uterus is the most common solid pelvic benign tumour in the female and occurs in nearly 20'Yo of all women during reproductive life.' The tumour increases in size during pregnancy or in response to exogenous oestro~en and regresses following menopause. -I For unknown reasons the incidence is much higher in the Negroid population than in Caucasians. I. 5. h Sufficient data are not available at present to suggest any conclusion regarding the aetiology of uterine leiomyomas. Nevertheless. it seems that leiomyomas arise from a single neoplastic parent cell derived from the smooth muscle elements of the myometrium and the growth of cells is influenced by various factors in the cellular environment. including the effect of steroid borrnones.""The concentration of oestrogen and progesterone receptors in human uterine leiomyoma and normal myometrium were measured in an attempt to clarify the relation of receptors to tumour growth in the Negroid population. We have also studied the concentrations of serum 17~oestradiol and progesterone with respect to steroid receptor concentrations in leiomyoma and normal myometrium at different phases of the menstrual cycle. Materials and methods PATIENTSEighteen women were included in the study. Each of these women had a hysterectomy for leiomyoma at Baragwanath Hospital. Criteria for patient selection included reproductive age, history of regular menstrual cycles and no history of exogenous hormone usage.The menstrual cycle dating was done by last menstrual period. by histologic evaluation of the endometrial specimen and serum progesterone levels. On the day of the operation a venous blood sample was obtained, allowed to clot and centrifuged. Serum was separated and frozen at -20°C. REAGENTSThe radioligands (2. 4, 6, 7 3H(N)) 17~oestra-diol, specific activity 95 Ci/rnmol. and 171~ methyl-3(lI)prornogesterone .263

Immunohistochemical Spectrum of GISTs at Different Sites and Their Differential Diagnosis with a Reference to CD117 (KIT)

“…These tumors do not only morphologically resemble uterine leiomyomas, but they also are positive for ER, which is similar to uterine leiomyomas (21,22) and dissimilar to GISTs, which are ER-negative according to our results. Therefore, ER immunostaining is a valuable aid to separate the uterine type leiomyomas from GISTs.…”

Etiology and pathogenesis of uterine leiomyomas: a review.

“…Strong evidence exists that the effect of estrogen is to increase the levels of both ER and PR in the myometrium, whereas the effect of progesterone is to decrease the level of the ER (Hsueh et al 1975;Katzenellenbogen 1980;Thi et al 1975). These conclusions are consistent with the sequential presentation of these two hormones during the menstrual cycle and the predominant observations that in the myometrium both ER and PR rise during the follicular (proliferative) phase and then fall during the luteal (secretory) phase of the menstrual cycle (Adams et al 1993;Buchi and Keller 1983;Englund et al 1998;Hsueh et al 1975;Janne et al 1975;Kawaguchi et al 1991;Lessl et al 1997;Marugo et al 1989;Rein et al 1990c;Sadan et al 1987;SchmidtGollwitzer et al 1979;Soules and McCarty 1982;Thi et al 1975). Because PR levels also fall during the luteal phase, some feel that progesterone may downregulate its own receptor (Englund et al 1998); this conclusion was also reached by Thi et al (1975), who demonstrated a fall in PR in the myometrium of ovariectomized guinea pigs when given progesterone (Thi et al 1975).…”

“…Interestingly, in one study (Marugo et al 1989) the ER and PR levels were significantly higher in submucous than subserosal leiomyomas, leading the authors to speculate about different etiologies and types of leiomyomas. The receptor concentrations were independent of the size of the tumor in one report (Sadan et al 1987). Another investigation found marked variation in ER and PR levels in different tumors from the same subject (Englund et al 1998); such heterogeneity may relate to the degree of hyalinization and involution of individual tumors.…”

“…In addition, Sadan et al found the ER and PR to be elevated in fibroids during all phases of the menstrual cycle when compared with matched myometria (Sadan et al 1987). Interestingly, in one study (Marugo et al 1989) the ER and PR levels were significantly higher in submucous than subserosal leiomyomas, leading the authors to speculate about different etiologies and types of leiomyomas.…”

“…In the majority of the studies reviewed, the concentrations of both the ERs and PRs were greater in leiomyomata than the myometrium Brandon et al 1993Brandon et al , 1995Buchi and Keller 1983;Eiletz et al 1980;Englund et al 1998;Kawaguchi et al 1991;Lessl et al 1997;Marugo et al 1989;Nisolle et al 1999;Otsuka et al 1989;Pollow et al 1978a;Puukka et al 1976;Rein et al 1990c;Sadan et al 1987;Soules and McCarty 1982;Tamaya et al 1979Tamaya et al , 1985Vij et al 1990;Viville et al 1997;Vollenhoven et al 1994;Wilson et al 1980). In addition, Sadan et al found the ER and PR to be elevated in fibroids during all phases of the menstrual cycle when compared with matched myometria (Sadan et al 1987).…”