Endometrial carcinoma, steroid receptor content

Endometrioid carcinomas are associated with hormone replacement therapy and endometrial hyperplasia; they express ER and PR. Clear cell and serous endometrial carcinomas tend to occur in older women against a background of endometrial atrophy and are unassociated with hormone replacement therapy. Some clear cell carcinomas show the architectural (papillary and glandular patterns) and cytological (large, bizarre and markedly pleomorphic nuclei) appearances of serous carcinoma. Serous carcinomas over-express p53.

	oestrogen receptor			progesterone receptor
Staining category	I key to categories proportion of nuclei staining 0-25% 26-75% >75% intensity of staining absent or weak I II II strong II II III very strong II III III	II key to categories proportion of nuclei staining 0-25% 26-75% >75% intensity of staining absent or weak I II II strong II II III very strong II III III	III key to categories proportion of nuclei staining 0-25% 26-75% >75% intensity of staining absent or weak I II II strong II II III very strong II III III	I	II	III
endometrioid	37/1261	45/1261	44/1261	60/126	39/126	27/126
adenoacanthoma	3/161	8/161	5/161	9/16	5/16	2/16
adenosquamous	8/141	5/141	1/141	11/14	2/14	1/14
serous	17/201	2/201	1/201	16/20	3/20	1/20
clear cell	5/51	0/51	0/51	5/5	0/5	0/5
undifferentiated	2/21	0/21	0/21	2/2	0/2	0/2

There is an inverse correlation between FIGO grade and both ER and PR positivity.

Others have used different assessment methodologies, but have also shown a higher level of steroid receptor expression in endometrioid carcinoma than other types, along with a lower expression of p53 and Ki67²:

subtype:	number of cases	oestrogen receptor	progesterone receptor	p53	Ki67
endometrioid	77	4 (0-12)	6 (0-12)	1 (0-12)	21 (5-50)
serous	30	1 (0-3)	1 (0-8)	12 (0-12)	53 (21-80)
typical clear cell	7	0 (0-2)	0 (0-1)	2 (0-6)	39 (30-60)
serous clear cell	14	0 (0-2)	1 (0-9)	3 (0-12)	49 (16-70)
		first figure is the mean, figures in brackets are ranges
		score = staining intensity (negative = 0, weak = 1, moderate = 2, strong = 3) x score for percentage of nuclei immunoreactive (<10% = 1, 11-50% = 2, 51-80% = 3, >81% = 4)			percentage of positive nuclei

References

¹Carcangiu, M. L., J. T. Chambers, et al. (1990). "Immunohistochemical evaluation of estrogen and progesterone receptor content in 183 patients with endometrial carcinoma. Part I: Clinical and histologic correlations." Am J Clin Pathol 94(3): 247-54.

²Lax, S. F., E. S. Pizer, et al. (1998). "Clear cell carcinoma of the endometrium is characterized by a distinctive profile of p53, Ki-67, estrogen, and progesterone receptor expression." Hum Pathol 29(6): 551-8.

This page last revised 25.1.2004.

©SMUHT/PW Bishop