IMMUNOHISTOCHEMISTRY IN ENDOMETRIAL HYPERPLASIA AND ENDOMETRIAL ADENOCARCINOMA

Aim: Endometrial hyperplasia is a proliferation of endometrial glands due to the prolonged stimulation with estrogens of the endometrium that occurs in women receiving exogenous estrogens, with anovulatory cycles, or in patients with ovarian tumours with estrogen secretion. Material and methods: The study performed by the authors included 575 patients with endometrial hyperplasia and 163 patients with endometrial adenocarcinoma admitted to the "Cuza-Voda" Obstetrics and Gynaecology Clinical Hospital of Iasi, between 2005-2007. Results: There were selected, for these immunohistochemistry reactions, 22 cases of simple hyperplasia without atypia, 26 cases of complex hyperplasia without atypia, 23 cases of endometrial adenocarcinoma of endometrioid type, well differentiated, 22 cases of endometrial adenocarcinoma of endometrioid type, moderately differentiated, and 19 cases of non-endometrioid adenocarcinomas represented by nine clear cells and 10 serous endometrial adenocarcinomas. Estrogen receptors have been positive in about 85-90% of the tumour cells of the well-differentiated endometrial adenocarcinomas of endometrioid type (GI). In endometrioid-type endometrial adenocarcinomas moderately differentiated (GII), the estrogen receptors were positive in approximately 70-85% of the tumour cells. Conclusions: Endometrial hyperplasia, especially complex endometrial hyperplasia with atypia, increase the risk for endometrial adenocarcinoma, and their early detection becomes mandatory under cancer prevention. Well-differentiated endometrioid endometrial adenocarcinomas were ER and PR-positive, so that the ER expression correlated with the PR expression. Well-differentiated endometrioid endometrial adenocarcinomas (GI) in the studied group also showed a higher content of ER and PR compared to the endometrial moderately-differentiated endometrioid endometrial adenocarcinomas (GII). In non-endometrioid adenocarcinomas, represented by clear-cell endometrial adenocarcinomas, the ER content was reduced and the PR expression was negative. Serous adenocarcinomas failed to show an immunohistochemically expression for ER and PR.