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Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study

Permanent lenke
https://hdl.handle.net/10037/17109
DOI
https://doi.org/10.1111/1471-0528.15579
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article.pdf (893.1Kb)
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Dato
2019-01-25
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Forfatter
Sletten, Elise Thoresen; Arnes, Marit; Lyså, Lena Marianne Myreng; Larsen, Marthe; Ørbo, Anne
Sammendrag

Objective - After successful progestin therapy for endometrial hyperplasia (EH), the risk of relapse remains. We aimed to assess if immunohistochemical (IHC) expression of progesterone receptor isoforms, PR‐A and PR‐B, in endometrial glands and stroma in pre‐treatment endometrial biopsies was related to relapse of EH.

Design and setting - Biopsy material originated from women with low‐risk and medium‐risk EH recruited to a recent Norwegian multicentre randomised trial. Participants (n = 153) had been treated for 6 months with three different progestin regimens.

Population - One hundred and thirty‐five of the 153 women achieved therapy response and underwent follow up for 24 months after therapy withdrawal. Fifty‐five women relapsed during follow up. Pre‐treatment endometrial biopsies from 94 of the 135 responding women were available for IHC staining.

Methods - Immunohistochemical staining was performed separately for PR‐A and PR‐B and IHC expression was evaluated in endometrial glands and stroma by a histological score (H‐score) using light microscopy.

Main outcome measure - Immunohistochemical expression of PR‐A and PR‐B in endometrial glands and stroma in women with or without relapse of EH.

Results - Low PR‐A in endometrial glands (P = 0.013) and stroma (P < 0.001), and high PR‐B in endometrial glands (P = 0.001) in pre‐treatment endometrial biopsy have a statistically significant association with relapse of EH. Women with a pre‐treatment ratio of PR‐A:PR‐B ≤ 1 have a higher risk of relapse (71%) compared with women with a ratio of PR‐A:PR‐B > 1 (19%; P < 0.001).

Conclusion - Immunohistochemical expression of PR‐A and PR‐B in pre‐treatment endometrial biopsy proves valuable as a predictor of relapse in EH.

Beskrivelse
This is the peer reviewed version of the following article: Sletten, E.T., Arnes, M., Lyså, L.M., Larsen, M. & Ørbo, A. (2019). Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study. BJOG: an International Journal of Obstetrics and Gynaecology, 126(7), 936-943, which has been published in final form at https://doi.org/10.1111/1471-0528.15579. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Forlag
Wiley
Sitering
Sletten, E.T., Arnes, M., Lyså, L.M., Larsen, M. & Ørbo, A. (2019). Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study. BJOG: an International Journal of Obstetrics and Gynaecology, 126(7), 936-943. https://doi.org/10.1111/1471-0528.15579
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  • Artikler, rapporter og annet (medisinsk biologi) [1105]
© 2018 Royal College of Obstetricians and Gynaecologists

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