Characteristics of endometrial hormonal homeostasis and receptor apparatus in women with adenomyosus who had papillary thyroid carcinoma
DOI:
https://doi.org/10.18370/2309-4117.2022.65.101-106Keywords:
adenomyosis, thyroid cancer, hormonal status, eutopic endometrium, estrogen receptors, progesterone receptorsAbstract
Objectives: to evaluate the hormonal status and receptor apparatus of the eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma.
Materials and methods. 63 women were examined: group I consisted of 31 patients with adenomyosis and papillary carcinoma of the thyroid gland in history, group II consisted of 32 patients with adenomyosis and unencumbered thyroid status. The severity of pelvic pain was assessed using a visual analog scale. The level of luteinizing and follicle-stimulating hormones, estradiol, prolactin, thyroid-stimulating hormone and progesterone was determined in the peripheral blood serum. The material for the morphological study was obtained using endometrial pipelle biopsy. Morphological research was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). Immunohistochemical study was performed on 20 paraffin sections (10 samples from patients of group I and 10 samples from patients of group II) using monoclonal antibodies.
Results. High ER-α expression was detected in the endometrial glandular epithelial cells (EGECs) in 80 and 50% of samples of patients from groups I and II, respectively (р < 0.05), no significant difference in
the number of positive cells was found between groups. High ER-α expression in endometrial stromal cells (ESCs) was detected in 50% of samples in patients from both groups, the number of positive cells was significantly higher in the endometrium specimens from I group (84.0 (10.5%) in group I versus 62.2 (12.3%) in group II, р < 0.05).
High PgR expression in the EGECs was detected in 90 and 75% of samples in groups I and II respectively (р < 0.05), ESCs expressed PgR in 100% of samples of patients from both groups. Significant difference in the number of positive cells was found between groups – 96.0 (8.4%) and 84.9 (12.6%) in groups I and II respectively, р < 0.05.
Conclusions. Our results suggest that the ectopic endometrium in female thyroid cancer survivors with adenomyosis has high expression of ER and PgR, that may have important implications for the survival and proliferation of the eutopic endometrial cells. Further research is needed to optimise prevention and treatment algorithms for this group of patients.
References
- Stratopoulou, C.A., Donnez, J., Dolmans, M.M. “Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far.” Reprod Sci 28 (2021): 2087–97. DOI: 10.1007/s43032-020-00361-w
- Yeh, C.-C., Su, F.-H., Tzeng, C.-R., et al. “Women with adenomyosis are at higher risks of endometrial and thyroid cancers: A population-based historical cohort study.” PLoS One 13.3 (2018): e0194011. DOI: 10.1371/journal.pone.0194011
- Heikinheimo, O., But, A., Lassus, H., et al. “A Nationwide Cohort Study on the risk of non-gynecological cancers in women with surgically verified endometriosis.” Int J Cancer 143.11 (2018): 2725–31. DOI: 10.1002/ijc.31721
- Guenego, A., Mesrine, S., Dartois, L., et al. “Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort.” Clin Endocrinol (Oxf) 90.2 (2019): 360–8. DOI: 10.1111/cen.13899
- Chapron, C., Vannuccini, S., Santulli, P., et al. “Diagnosing adenomyosis: An integrated clinical and imaging approach.” Hum Reprod Update 26.3 (2020): 392–411. DOI: 10.1093/humupd/dmz049
- García-Solares, J., Donnez, J., Donnez, O., Dolmans, M.-M. “Pathogenesis of uterine adenomyosis: invagination or metaplasia?” Fertil Steril 109.3 (2018): 371–9. DOI: 10.1016/J.FERTNSTERT.2017.12.030
- Yu, O., Schulze-Rath, R., Grafton, J., et al. “Adenomyosis incidence, prevalence and treatment: United States population-based study 2006–2015.” Am J Obstet Gynecol 223.1 (2020): 94.e1–94.e10. Available from: [https://pubmed.ncbi.nlm.nih. gov/31954156/], last accessed May 25, 2022. DOI: 10.1016/J.AJOG.2020.01.016
- Alcalde, A.M., Martínez-Zamora, M.Á., Gracia, M., et al. “Impact of Adenomyosis on Women’s Psychological Health and Work Productivity: A Comparative Cross-Sectional Study.” J Women’s Health 30.11 (2021): 1653–9. Available from: [https://www.liebertpub. com/doi/abs/10.1089/jwh.2020.8789], last accessed Jan 5, 2022. DOI: 10.1089/jwh.2020.8789
- Alcalde, A.M., Martínez-Zamora, M.Á., Gracia, M., et al. “Assessment of Quality of Life, Sexual Quality of Life, and Pain Symptoms in Deep Infiltrating Endometriosis Patients with or Without Associated Adenomyosis and the Influence of a Flexible Extended Combined Oral Contraceptive Regimen: Results of a Prospective, Observational Study.” J Sex Med 19.2 (2022): 311–8. Available from: [https://pubmed.ncbi.nlm.nih.gov/34974988/]. last accessed Feb 12, 2022. DOI: 10.1016/J.JSXM.2021.11.015
- Danylova, A. “Quality of life of women with a history of adenomyosis and papillary thyroid carcinoma.” Reproductive health of woman 1 (2022): 63–8. Available from: [http://repro-health.com.ua/article/view/258143], last accessed Jun 12, 2022. DOI: 10.30841/2708-8731.1.2022.258143
- Van Den Bosch, T., Dueholm, M., Leone, F.P.G., et al. “Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: A consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group.” Ultrasound Obstet Gynecol 46.3 (2015): 284–98. DOI: 10.1002/uog.14806
- Harmsen, M.J., Van den Bosch, T., Leeuw, R.A., et al. “Consensus on revised definitions of morphological uterus sonographic assessment (MUSA) features of adenomyosis: results of a modified Delphi procedure.” Ultrasound Obstet Gynecol (2021). Available from: [https://pubmed.ncbi.nlm.nih. gov/34587658/ 10.1002/uog.24786], last accessed May 25, 2022. DOI: 10.1002/uog.24786
- Zhai, J., Vannuccini, S., Petraglia, F., Giudice, L.C. “Adenomyosis: Mechanisms and Pathogenesis.” Semin Reprod Med 38.2–03 (2020): 129–43. Available from: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932680/], last accessed May 21, 2022. DOI: 10.1055/S-0040-1716687
- Kitawaki, J. “Adenomyosis: the pathophysiology of an oestrogen-dependent disease.” Best Pract Res Clin Obstet Gynaecol 20.4 (2006): 493–502. DOI: 10.1016/j.bpobgyn.2006.01.010
- Takahashi, K., Nagata, H., Kitao, M. “Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis.” Nihon Sanka Fujinka Gakkai Zasshi 41.11 (1989): 1849–50. PMID: 2592808.
- Yen, C.F., Huang, S.J., Lee, C.L., et al. “Molecular Characteristics of the Endometrium in Uterine Adenomyosis and Its Biochemical Microenvironment.” Reprod Sci 24.10 (2017): 1346–61. Available from: [https://pubmed.ncbi. nlm.nih.gov/28183227/], last accessed Jul 5, 2021. DOI: 10.1177/1933719117691141
- Zahid, M., Goldner, W., Beseler, C.L., et al. “Unbalanced estrogen metabolism in thyroid cancer.” Int J Cancer 133.11 (2013): 2642–9. Available from: [http://www.ncbi.nlm.nih.gov/pubmed/23686454], last accessed Mar 30, 2019. DOI: 10.1002/ijc.28275
- Herndon, C.N., Aghajanova, L., Balayan, S., et al. “Global Transcriptome Abnormalities of the Eutopic Endometrium from Women with Adenomyosis.” Reprod Sci 23.10 (2016): 1289–1303. DOI: 10.1177/1933719116650758
- Mehasseb, M.K., Panchal, R., Taylor, A.H., et al. “Estrogen and progesterone receptor isoform distribution through the menstrual cycle in uteri with and without adenomyosis.” Fertil Steril 95.7 (2011): 2228–35.e1. Available from: [http://www. fertstert.org/article/S0015028211003608/fulltext], last accessed May 28, 2021. DOI: 10.1016/j.fertnstert.2011.02.051
- Migliaccio, A., Di Domenico, M., Castoria, G., et al. “Tyrosine kinase/p21ras/MAP-kinase pathway activation by estradiol-receptor complex in MCF-7 cells.” EMBO J 15.6 (1996): 1292–300. DOI: 10.1002/j.1460-2075.1996.tb00471.x
- O’Brien, J.E., Peterson, T.J., Ming, H.T., et al. “Estrogen-induced Proliferation of Uterine Epithelial Cells Is Independent of Estrogen Receptor alpha Binding to Classical Estrogen Response Elements.” J Biol Chem 281.36 (2006): 26683–92. Available from: [http://www.jbc.org/article/S0021925819351993/fulltext], last accessed Dec 9, 2021. DOI: 10.1074/jbc.M601522200
- Stefkovich, M.L., Arao, Y., Hamilton, K.J., Korach, K.S. “Experimental Models for Evaluating Non-Genomic Estrogen Signaling.” Steroids 133 (2018): 34–7. DOI: 10.1016/j.steroids.2017.11.001
- Donnez, J., Stratopoulou, C.A., Dolmans, M.M. “Uterine Adenomyosis: From Disease Pathogenesis to a New Medical Approach Using GnRH Antagonists.” Int J Environ Res Public Health 18.19 (2021): 9941. Available from: [https://pubmed. ncbi.nlm.nih.gov/34639243/], last accessed Nov 19, 2021. DOI: 10.3390/ijerph18199941
- Marquardt, R.M., Kim, T.H., Shin, J.H., Jeong, J.W. “Progesterone and Estrogen Signaling in the Endometrium: What Goes Wrong in Endometriosis?” Int J Mol Sci 20.15 (2019): 3822. Available from: [https://pubmed.ncbi.nlm.nih.gov/31387263/], last accessed May 25, 2022. DOI: 10.3390/ijms20153822
- Al-Sabbagh, M., Lam, E.W.F., Brosens, J.J. “Mechanisms of endometrial progesterone resistance.” Mol Cell Endocrinol 358.2 (2012): 208–15. Available from: [https://pubmed.ncbi.nlm. nih.gov/22085558/], last accessed May 25, 2022. DOI: 10.1016/j.mce.2011.10.035
- Kitawaki, J., Koshiba, H., Ishihara, H., et al. “Progesterone induction of 17beta-hydroxysteroid dehydrogenase type 2 during the secretory phase occurs in the endometrium of estrogen-dependent benign diseases but not in normal endometrium.” J Clin Endocrinol Metab 85.9 (2000): 3292–6. Available from: [https://pubmed.ncbi.nlm.nih. gov/10999824/], last accessed May 25, 2022. DOI: 10.1210/jcem.85.9.6829
- Bulun, S.E., Cheng, Y.H., Yin, P., et al. “Progesterone resistance in endometriosis: link to failure to metabolize estradiol.” Mol Cell Endocrinol 248.1–2 (2006): 94–103. Available from: [https://pubmed.ncbi.nlm.nih.gov/16406281/], last accessed May 25, 2022. DOI: 10.1016/j. mce.2005.11.041
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 А.О. Данилова, Л.В. Калугіна, Н.В. Косей, А.М. Кваченюк, І.Л. Аветіс’ян, I.П. Маноляк
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.