Tamoxifen use and endometrial lesions: hysteroscopic, histological, and immunohistochemical findings in postmenopausal women with breast cancer

被引:25
作者
Dibi, Raquel P. [1 ,2 ]
Zettler, Claudio G. [2 ,3 ]
Pessini, Suzana A. [1 ]
Ayub, Alice V. [1 ]
de Almeida, Suzane B. [1 ]
da Silveira, Gustavo P. G. [1 ,2 ]
机构
[1] Complexo Hosp Santa Casa Porto Alegre, Dept Gynecol, Porto Alegre, RS, Brazil
[2] Fundacao Fac Fed Ciencias Med Porto Alegre, Postgrad Program Pathol, Porto Alegre, RS, Brazil
[3] Complexo Hosp Santa Casa Porto Alegre, Dept Pathol, Porto Alegre, RS, Brazil
来源
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY | 2009年 / 16卷 / 02期
关键词
Endometrium; Tamoxifen; Menopause; Ki-67; Estrogen receptor; Progesterone receptor; PATIENTS RECEIVING TAMOXIFEN; FEMALE GENITAL-TRACT; ADJUVANT TAMOXIFEN; TREATED PATIENTS; TRANSVAGINAL ULTRASONOGRAPHY; RECEPTOR EXPRESSION; POLYPS; THERAPY; ULTRASOUND; PROLIFERATION;
D O I
10.1097/gme.0b013e31818af10a
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To evaluate immunohistochemical, hysteroscopic, and histological findings in postmenopausal women taking tamoxifen for breast cancer. Methods: Forty postmenopausal women taking 20 mg/day tamoxifen for breast cancer underwent hysteroscopy and endometrial biopsy from January 2000 to December 2003. Medical records and paraffin blocks were analyzed retrospectively, and Ki-67, estrogen receptors (ERs), and progesterone receptors were measured using all immunohistochemical technique. Results: The mean +/- SD age of the women was 59 +/- 14 years at hysteroscopy (95% CI, 54.2-63.7) and 45.1 +/- 7 years at menopause (95% CI, 42.6-47.6). Mean +/- SD duration of tamoxifen therapy was 27.3 +/- 16.5 months (95% CI, 22.0-32.5). Hysteroscopies were performed because of abnormal sonographic findings in 60% of the women and postmenopausal bleeding in 40%. The most common hysteroscopic and histological findings were endometrial polyps (32.5%) and atrophic endometria (22.5%). Immunohistochemistry showed that 85% of the women were progesterone receptor positive, 75% were ER positive, and 50% were Ki-67 positive. Endometrial polyps and polyps associated with atrophic endometrium were ER positive (P = 0.019). Results that were ER negative were more frequent in atrophic endometria (P = 0.01). The longer the time since menopause, the lower the Ki-67 expression in the endometrium was (P = 0.03). Ki-67 expression was greater in the endometrium of younger postmenopausal women (P = 0.01). Conclusions: The expression of steroid receptors in the endometrium was high in our series. All cases of endometrial polyps were ER positive. Estrogen receptors may play a major role in the development of endometrial polyps in postmenopausal women taking tamoxifen. Although most histological findings were benign, 22.5% were atrophic.
引用
收藏
页码:293 / 300
页数:8
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