Progesterone receptors in two groups of endometrial carcinoma

Abstract

A previous study evaluated two types of endometrial carcinoma: one with, the other without, associated adenomatous hyperplasia (Groups 1 and 2, respectively). On the basis of histologic observations, the study concluded that Group 1 tumors were likely to be estrogen-dependent, whereas Group 2 tumors appeared to represent a hormone-independent type of cancer. The authors present quantitative biochemical data to support the proposition that Group 1 tumors are likely to be under the influence of estrogen. Progesterone receptor levels, known to be increased by estradiol, were significantly higher in Group 1 than in Group 2. Analysis of histologic variants revealed that some histologic components, such as mucinous adenocarcinoma, squamous components, and stromal foam cells, predominated in Group 1 and may, therefore, be indicative of estrogen action. Certain histologic features, however, such as papillary carcinoma, clear cells, and anaplastic carcinoma with giant tumor cells, were found exclusively in Group 2, thus suggesting a lack of estrogenic influence. These findings indicate that Group 1 and Group 2 endometrial carcinomas may constitute two different biologic entities and, thus, encourage further basic and clinical research to develop specific therapies for patients diagnosed to have endometrial cancer.

Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective

“…The distinction between these two types was later utterly refined by histopathological subtyping and immunohistochemical profiling: high proportion of endometrioid histological subtype, estrogen and progesterone receptors positivity in Type I cancers while Type II cancers were dominated by non-endometrioid histological subtypes including serous papillary, clear cell and undifferentiated subtypes, and loss of hormone receptors. 13,14 Excess estrogen relative to progesterone stimulates endometrial-cell proliferation, inhibits apoptosis and promotes angiogenesis 5,15 , all processes in favour of carcinogenesis. Conditions leading to long-term estrogen overexpression relative to the expression of progesterone promote increased risk of Type I endometrial cancer: obesity, persistent anovulation, nulliparity, tamoxifen use and HRT without concomitant progestin substitution.…”

Hormonal Pathology of the Endometrium

“…The intensity of the response correlates with the receptor levels (28,29). This therapy produces an arrest of glandular proliferation, with secretory changes in the glands and decidual reaction in the stroma.…”

Autophagy in endometrial carcinomas and prognostic relevance of 'stone-like' structures (SLS): What is destined for the atypical endometrial hyperplasia?

“…The former may be separated from the main group of nonendometrioid carcinomas and considered together with the G 1 endometrioid carcinomas not solely on the basis of an almost excellent prognosis, but also on histological groundthey have an architectural resemblance with well-differentiated endometrioid adenocarcinomas which is typified by a glandular pattern and a low nuclear grade. [43][44][45][46] With regard to the propensity of adenosquamous carcinomas to run an indolent clinical course, 45,[47][48][49][50] this leaves us with little justification for its continued taxonomic separation from adenoacanthoma-the two are frequently classed into a single entity of G 1 endometrioid adenocarcinoma with squamous differentiation.…”