Immunohistochemical characteristics of endometrium hyperplasia in comparison with secretory endometrium

Authors

DOI:

https://doi.org/10.26641/1997-9665.2023.2.66-74

Keywords:

endometrium, endometrial hyperplasia, endometrial hyperplasia without atypia, atypical endometrial hyperplasia, immunohistochemistry, prognosis.

Abstract

Background. Endometrial hyperplasia (HE) is a pathological increase in the number of cells of the endometrial epithelium, which, in the case of atypical proliferation, is considered a precancerous condition and leads to the development of endometrial carcinoma. The method of immunohistochemically staining plays a significant role in the differential diagnosis of GE without/with atypia and carcinomas. Objective. The aim of this work is the comparative characterization of the expression of immunohistochemically markers in three types of endometrium: endometrial hyperplasia without atypia, endometrial hyperplasia with atypia and secretory endometrium, in order to determine the most informative markers that can serve as diagnostic supplements and prognostic indicators for the transition from endometrial hyperplasia to carcinoma. Methods. The study was performed on endometrial biopsy material from 23 women of reproductive age with abnormal uterine bleeding by curettage, who were diagnosed with GE without/with atypia, 7 women made up the control group with endometrial secretory changes. The expression of progesterone (PR) and estrogen (ER) receptors, as well as p21, dcl-2, KI-67, eNOS, cyclin D1, BAX, b-catenin, E-cadherin and Caspase 3 markers were compared in order to determine the most informative markers that can serve as diagnostic adjuncts and prognostic indicators for the transition from GE to carcinoma. Results. The obtained results indicate a difference in the expression levels of immunohistochemically markers in different types of endometrium. These results are important for further research into the mechanisms of endometrial hyperplasia development and may indicate potential therapeutic targets for the selection of treatment strategies for different types of hyperplasia. Conclusion. The difference between the group of hyperplasia without atypia and the control group of secretory endometrium in the glandular component was demonstrated by markers ER, PgR, b-catenin, p21, cyclin D1, Ki-67, Caspasa-3 (all p<0.05); and in the stromal component - ER, PgR, b-catenin (all p<0.05), which gives reason to use them as the main diagnostic markers. The difference between the group of hyperplasia with atypia and the control group of the secretory endometrium in the glandular component was demonstrated by markers ER, b-catenin, p21, cyclin D1, Ki-67, eNOS (all p<0.05); and in the stromal component - ER, b-catenin and eNOS (all p<0.05), which gives reason to use them as the main diagnostic markers. The difference between the group of hyperplasia without atypia and the group of hyperplasia with atypia in the glandular component was demonstrated by markers PgR, Ki-67, Caspasa-3 eNOS (all p<0.05); and in the stromal component - eNOS (p<0.05), which gives reason to use them as the main diagnostic and prognostic markers. Bcl-2 and BAX markers did not show a statistically significant difference in the study groups, which indicates the impossibility of using them separately as diagnostic or prognostic markers for endometrial hyperplastic processes, and the interpretation of the expression results of these markers must be taken into account in combination with other indicators.

References

  1. Ramos-Vara JA. Principles and Methods of Immunohistochemistry. Methods in molecular biology : Clifton, 2017;1641:115–128. https://doi.org/10.1007/978-1-4939-7172-5_5
  2. Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017;23(2):232-254. doi: 10.1093/humupd/dmw042. PMID: 27920066; PMCID: PMC5850217.
  3. Owings RA, Quick CM. Endometrial intraepithelial neoplasia. Arch Pathol Lab Med. 2014;138:484–491.
  4. Gromova O, Potapov O, Khaskhachykh D, Gaponova, Kukina G. Receptors of endometrium in premenopausal women with different morphotypes of endometrial hyperplasia. Neonatology, surgery and perinatal medicine. 2021;1(39):33-8. Ukrainian. DOI: 10.24061/2413-4260.XI.1.39.2021.5
  5. Antunes A, Vassallo J, Pinheiro A, Leao R, Pinto Neto AM, Costa-Paiva L. Immunohistochemical expression of estrogen and progesterone receptors in endometrial polyps: A comparison between benign and malignant polyps in postmenopausal patients. Oncol Lett. 2014;7(6):1944-1950. doi: 10.3892/ol.2014.2004
  6. Ahmed RH, Ahme E, Muhammad MS. E-cadherin and CD10 expression in atypical hyperplastic and malignant endometrial lesionsю. Journal of the Egyptian National Cancer Institute. 2014;26(4):211-217. https://doi.org/10.1016/j.jnci.2014.08.002.
  7. Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Updat. 2017;23(2):232–254.
  8. de Groot JS, Ratze MA, van Amersfoort M, Eisemann T, Vlug EJ, Niklaas MT, Chin SF, Caldas C, van Diest PJ, Jonkers J, de Rooij J, Derksen PW. αE-catenin is a candidate tumor suppressor for the development of E-cadherin-expressing lobular-type breast cancer. J Pathol. 2018;245(4):456-467. doi: 10.1002/path.5099.
  9. Shevra CR, Ghosh A, Kumar M. Cyclin D1 and Ki-67 expression in normal, hyperplastic and neoplastic endometrium. J Postgrad Med. 2015;61(1):15-20. doi: 10.4103/0022-3859.147025.
  10. Najafi T, Ghaffari Novin M, Pakravesh J, Foghi K, Fadayi F, Rahimi G. Immunohistochemical localization of endothelial nitric oxide synthase in endometrial tissue of women with unexplained infertility. IJRM 2012;10(2):121-126. URL: http://ijrm.ir/article-1-263-en.html
  11. Silkova OV, Lobach NV (editors). [Medical informatics: study guide]. Ministry of Health of Ukraine, UMSA, Poltava: ASMI, 2016. 262 p. Ukrainian. PMID: 28203752.
  12. Bendifallah S, Genin AS, Naoura I, Chabbert-Buffet N, Bolze PA. The impact of endometrial thickness changes in patients with simple hyperplasia without atypia. European journal of obstetrics, gynecology, and reproductive biology. 2018;224:75-81.
  13. Bhattacharjee M, Chakraborty P, Mukherjee A, Mukherjee S. Association of PTEN and progesterone receptor expressions in endometrial hyperplasia without atypia and early-stage endometrial adenocarcinoma. Journal of mid-life health. 2019;10(3):128.
  14. Dall'Agnol MA, Dias JA. Endometrial hyperplasia: a review for clinical practice. Clinics.2019;74:e1189.
  15. Khaskhachikh DA, Potapov VO, Kukina GO. A differentiated approach to the treatment of endometrial hyperplasia without atypia in women of reproductive age. Current issues of pediatrics, obstetrics and gynecology. 2019;2(24):149-54. Ukrainian. DOI: 10.11603/24116-4944.2019.2.10935

Downloads

Published

2025-04-19

How to Cite

Khaskhachikh , D., Potapov , V., & Poslavska , O. (2025). Immunohistochemical characteristics of endometrium hyperplasia in comparison with secretory endometrium. Морфологія / Morphologia / Morfologìâ, 17(2), 66–74. https://doi.org/10.26641/1997-9665.2023.2.66-74

Issue

Vol. 17 No. 2 (2023)

Section

Статті

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.