Prognostic significance of estrogen and progesterone receptor expression in LNG-IUS (Mirena>®) treatment of endometrial hyperplasia: an immunohistochemical study

E Akesson, Ioannis Gallos, Raji Ganesan, R Varma, Janesh Gupta

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

We performed immunohistochemical analysis of estrogen (ERalpha) and progesterone receptors (PRA and PRB), phosphatase and tensin homolog (PTEN) and aromatase in endometrial hyperplasia treated with Mirena (levonorgestrel-releasing intrauterine system; LNG-IUS) and explored their prognostic significance. The baseline pre-treatment endometrial hyperplasia of a selected prospective cohort was analyzed [complex (n = 29) and atypical (n = 5)]. Study participants were categorized into those that showed endometrial regression (responders, n = 28) and those that showed non-regression or histological progression to atypia or malignancy (non-responders, n = 6). Immunohistochemical expression was expressed as a histological score (HS). Responders compared to non-responders showed significantly higher HSs for estrogen and progesterone receptors. Absence of estrogen and progesterone receptors predicted non-responder status with likelihood ratios of 9.33 (95% CI 2.19-39.81) and 2.92 (95% CI 1.47-5.79), respectively. Neither PTEN nor aromatase expression were associated with LNG-IUS therapy responsiveness. Responsiveness of endometrial hyperplasia to LNG-IUS therapy may be determined through analysis of baseline estrogen and progesterone receptors, but these exploratory findings require confirmation in a larger dataset.
Original languageEnglish
Pages (from-to)393-398
Number of pages6
JournalActa obstetricia et gynecologica Scandinavica
Volume89
Issue number3
DOIs
Publication statusPublished - 1 Mar 2010

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