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Apoptosis, proliferation, and sex steroid receptors in endometrium and endometrial carcinoma
Umeå University, Faculty of Medicine, Clinical Sciences, Obstetrics and Gynaecology. Umeå University, Faculty of Medicine, Radiation Sciences, Oncology. Umeå University, Faculty of Medicine, Medical Biosciences, Pathology.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on the involvement of apoptosis and proliferation in the mechanisms of menstruation and hormonal replacement therapy, HRT, as well as in the mechanisms of progesterone therapy in endometrial carcinoma.

The aim of the first study was to investigate endometrium for 4 days before and for 2 days during menstruation. In the epithelium, rapid increase in the apoptotic index, decreasing expression of estrogen receptor α (ER) and progesterone receptor (PR), and minimal proliferation were observed prior to menstruation. In the stroma, an increase in the expression of ER and PR and proliferation was seen before the final decrease, and increased apoptosis was seen during menstruation. Thus, apoptosis is involved in the remodeling of the endometrium during menstruation.

Postmenopausal endometrium showed unaffected homeostasis, i.e. unchanged ratio between apoptotic index and Ki-67 index during substitution therapy. ER expression was decreased both in the epithelium and stroma, while PR showed some increase in receptor expression. The unchanged homeostasis contributes to endometrial safety during combined continuous HRT.

Unchanged apoptosis and increasing proliferation were observed with increasing tumor grade in 29 patients with endometrioid endometrial carcinoma, which may contribute to greater aggression as tumor grade increases. Decreased proliferation was observed after medroxy-progesterone at 20 mg per day particularly in the foci of maximal proliferation in G1 and G2 tumors. The expression of ER was unchanged, while PR was decreased in the foci of maximal expression for PR in G1 and G2 tumors. Since high proliferation and PR expression also coexisted in the same foci, evaluated in G1 and G2 tumors, the effect of progesterone could be facilitated in these tumor groups. High expression of sex steroid receptors was also a predicting factor for good response to progesterone (= decrease in proliferation), while the amount of stroma could not predict that effect.

Place, publisher, year, edition, pages
2003. , 83 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 854
Keyword [en]
Medicine, estradiol, progesterone, steroid receptors, apoptosis, proliferation, endometrial carcinoma, Ki-67, p53, immunohistochemistry
Keyword [sv]
Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Medicine
Identifiers
URN: urn:nbn:se:umu:diva-112ISBN: 91-7305-522-0 (print)OAI: oai:DiVA.org:umu-112DiVA: diva2:140268
Public defence
2003-10-17, EO4, 6E, Umeå, 09:15 (English)
Opponent
Supervisors
Available from: 2003-09-29 Created: 2003-09-29 Last updated: 2009-09-23Bibliographically approved
List of papers
1. Apoptosis, proliferation and sex steroid receptors in superficial parts of human endometrium at the end of the secretory phase
Open this publication in new window or tab >>Apoptosis, proliferation and sex steroid receptors in superficial parts of human endometrium at the end of the secretory phase
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1999 In: J Clin Endocrinol Metab, Vol. 84, 1737-43 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-2319 (URN)
Available from: 2003-09-29 Created: 2003-09-29Bibliographically approved
2. Apoptosis, proliferation and sex steroid receptors in postmenopausal endometrium before and during HRT.
Open this publication in new window or tab >>Apoptosis, proliferation and sex steroid receptors in postmenopausal endometrium before and during HRT.
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(English)Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-2320 (URN)
Available from: 2003-09-29 Created: 2003-09-29 Last updated: 2010-08-31Bibliographically approved
3. Apoptosis, proliferation and sex hormone receptors in untreated endometrial adenocarcinoma: results depending on methods of analysis
Open this publication in new window or tab >>Apoptosis, proliferation and sex hormone receptors in untreated endometrial adenocarcinoma: results depending on methods of analysis
2003 In: Int J Oncol, Vol. 22, 115-122 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-2321 (URN)
Available from: 2003-09-29 Created: 2003-09-29Bibliographically approved
4. Intratumoral effects of medroxy-progesterone on proliferation, apoptosis, and sex steroid receptors in endometrioid endometrial adenocarcinoma
Open this publication in new window or tab >>Intratumoral effects of medroxy-progesterone on proliferation, apoptosis, and sex steroid receptors in endometrioid endometrial adenocarcinoma
2004 (English)In: Gynecol Oncol, ISSN 0090-8258, Vol. 92, no 1, 116-126 p.Article in journal (Refereed) Published
Keyword
Medroxy-progesterone, sex steroid receptors, endometrial carcinomas
Identifiers
urn:nbn:se:umu:diva-15041 (URN)doi:10.1016/j.ygyno.2003.10.021 (DOI)14751147 (PubMedID)
Available from: 2007-10-19 Created: 2007-10-19 Last updated: 2009-09-23Bibliographically approved

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