Progesterone Receptor Status of Epithelial Cells as a Predictive Marker for Postoperative Recurrence of Endometriosis
Progesterone Receptor Status of Epithelial Cells as a Predictive Marker for Postoperative Recurrence of Endometriosis
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DOI：
10.1210/clinem/dgac118
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发表时间：
2022-03-02
影响因子：
5.8
通讯作者：
Kitawaki, Jo
中科院分区：
文献类型：
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作者：
Tarumi, Yosuke;Mori, Taisuke;Kitawaki, Jo
研究背景包括孕激素受体(PR)缺乏在内的孕激素抵抗参与了子宫内膜异位症的病理生理过程；然而，卵巢子宫内膜异位症(OE)中PR的表达水平是否与子宫内膜异位症术后复发有关尚不清楚。目的探讨子宫内膜异位症患者子宫内膜组织中PR表达水平与复发的关系。方法对132例子宫内膜异位症保守性手术患者的子宫内膜标本进行分析。免疫组织化学染色后用H评分评价PR的表达水平。结果132例患者中36例(27.3%)复发，96例(72.7%)未复发。除随访期外，复发组与非复发组的患者特征差异无统计学意义。复发组上皮细胞(ECs)PR免疫反应性显著低于未复发组(P<0.01)，而间质细胞未见此变化。多因素Logistic回归分析显示，子宫内膜异位症患者PR的H评分是一个独立因素，与子宫内膜异位症的复发有统计学意义(P=0.01)。此外，我们将患者分为PR阴性组和PR阳性组。PR阴性组的累积复发率显著高于PR阳性组(P=0.046)。结论OE-ECs中PR的低表达可能预示着子宫内膜异位症的复发。OE-ECs中PR状态与子宫内膜异位症复发的病理生理机制有关，参考PR状态可为子宫内膜异位症提供最佳的术后处理。
Context Progesterone resistance including progesterone receptor (PR) deficiency contributes to the pathophysiology of endometriosis; however, whether the PR expression levels in ovarian endometrioma (OE) correlate with the postoperative recurrence of endometriosis remains unclear. Objective This study aimed to investigate the association between PR expression levels in OE and the recurrence of endometriosis. Methods OE specimens were obtained from 132 patients who underwent conservative surgery for endometriosis. The PR expression levels were evaluated using the H score after immunohistochemical staining. Results Of the 132 patients, 36 (27.3%) experienced recurrence and 96 (72.7%) did not. No differences were observed in the patient characteristics between the recurrence and nonrecurrence groups except for follow-up period. PR immunoreactivity in the epithelial cells (ECs) was statistically significantly lower in the recurrent group than in the nonrecurrent group (P < .01); however, this change was not observed in the stromal cells. Moreover, multivariable logistic regression analysis revealed that the H score of PR in ECs was an independent factor and was statistically significantly associated with the recurrence of endometriosis (P = .01). Furthermore, we divided the patients into PR-negative or PR-positive groups. The cumulative recurrence rate in the negative PR group was statistically significantly higher than that in the positive PR group (P = .046). Conclusion Low PR expression levels in OE-ECs may predict the recurrence of endometriosis. The PR status in OE-ECs is associated with the pathophysiology of the recurrence of endometriosis, and optimized postoperative management for endometriosis may be provided by referring to the PR status.