SEX STEROID HORMONE RECEPTOR EXPRESSION AND CELL PROLIFERATION IN DIFFERENT FORMS OF ENDOMETRIAL HYPERPLASIA. IMPACT OF THE LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM


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Abstract

Objective. To define the possible mechanisms of therapeutic action of a levonorgestrel-releasing intrauterine device (LNG-IUD) in different forms of endometrial hyperplasia (EH), by examining the expression of sex steroid receptors and the proliferative activity of endometrial cells. Subjects and methods. A comprehensive clinical and laboratory study was made in 112 women aged 18 to 50 years (mean age 40.80±7.02 years) with different forms of EH. A Mirena IUD as therapy for EH was inserted in all the patients on days 4—7 of a menstrual cycle. Eighty-two endometrial tissue samples were immunohistochemically analyzed. The LNG-IUD was found to exert similar effects on the expression of estrogen receptors-a (ER-a) in the glands and stroma in simple EH (SEH) and a more marked effect in the stroma in complex and atypical EH (CEH and AEH) while its action on the expression of progesterone receptors (PR) was more pronounced in the stroma and glands in SEH and CEH and less pronounced in AEH. The local effect of LNG was accompanied by the lower proliferative activity (a significant reduction in PCNA and Ki-67 expression), which was more marked in SEH and CEH than that in AEH. Irrespective of the form of EH, the LNG-IUD has a less marked impact on the stromal component of the endometrium than on the glandular one.

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G. E CHERNUKHA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: c-galina1@yandex.ru

T. V SHIGOREVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

O. A MOGIREVSKAYA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

A. V SILAKOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

V. N KASYAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

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