AI Summary & Key Takeaways
AI InsightThe hormone therapy may be the option for the alternative treatment of adenomyosis instead of surgery
📌 3 Key Takeaways
Abstract
Objective: The objective of this study was to investigate estrogen and progesteron receptor expression in adenomyotic and in eutopic endometrium in the patients with adenomyosis and to define the value of medical therapy as an option. Material and Methods: The specimens of the 39 patients with the diagnosis of adenomyosis who had operated because of myoma uteri, endometrial hyperplasia and postmenopausal bleeding were investigated. Estrogen and progesteron receptor concentrations were determined in these specimens immunohistochemically. The specimens prepared from the patients with adenomyosis, consisting of both adeno myotic foci and endometrium were evaluatad simultaneously. Results: The staining of the epithelium in both endometrium and adenomyosis foci for the estrogen receptors were almost the same (p>0.05). Lesser staining of the glands which have prominent secretory changes located in the functional layer of the endometrium, was quite a distinct feature among the specimens showing secretory changes on the surface. There was no statistically significant difference between the staining of the stroma for the estrogen receptors both in endometrium and adenomyotic foci (p>0.05). There was no significant difference between the staining of the epithelium in both endometrium and adenomyotic foci for the progesteron receptors (p>0.05). The staining of the stroma for the progesteron receptors both in endometrium and adenomyotic foci were statistically similar with regard to the staining intensity (p>0.05). Conclusion: ER and PR expressed in the eutopic and ectopic endometrium where they must have played important roles in promoting the development of adenomyosis. The hormone therapy may be the option for the alternative treatment of adenomyosis instead of surgery
Özet
Amaç: Adenomyozis olgularında eutopik endometrium ve adenomyotik dokudaki endometriumda östrojen-progesteron reseptör yoğunluğu incelendi ve adenomyoziste hormonal terapinin efektif olup olmadığı araştırıldı. Çalışmanın Yapıldığı Yer: Celal Bayar Üniversitesi Tıp Fakültesi, Kadın Hast. ve Doğum AD, Manisa Materyal ve Metod: Total histerektomi uygulanmış ve patolojik incelemelerinde adenomyosis tanısı almış 39 olgunun spesimenleri immunohistokimyasal yöntemlerle boyanarak adenomyotik fokuslarda ve normal endometriumdaki estrojen-progesteron reseptör yoğunlukları araştırıldı. Bulgular: Endometrium ve adenomyotik fokuslardaki epitel boyamalarında estrojen reseptörleri istatistiksel fark göstermemekteydi (p>0.05). Endometriumun fonksiyonel tabakasında belirgin sekretuar değişiklikler gösteren bezler, yüzey epitelindeki sekretuar bezlere oranla daha az boyanmıştı. Normal endometrium ve adenomyotik dokudaki stromada estrojen ve progesteron reseptör boyanmaları istatistiksel farklılık göstermemekteydi (p>0.05). Endometrium ve adenomyotik doku epiteli progesteron reseptör boyanması da istatistiksel olarak anlamlı farklılık göstermemekteydi (p>0.05). Sonuçlar:Adenomyosis gelişiminde rol oynadığı düşünülen estrojen ve progesteron reseptörleri eutopik ve ektopik endometriumda benzer oranlarda bulunmaktadır. Bu durum adenomyosis tedavisinde cerrahi yerine medikal tedaviyi de alternatif tedavi seçeneği olabileceğini ortaya koymaktadır.