Determining the Oestrogen and Progesterone Receptor Expression in Cases of Endometrial Carcinoma: A Cross-sectional Study

Abstract

Introduction: Endometrial carcinoma is the second most common female genital tract malignancy in India with a incidence rising globally. Hormone receptors are positive in 35- 90% of endometrial carcinomas. Hormone therapy can be given to patients with hormone receptor positive tumours. Aim: To determine whether Progesterone and Oestrogen receptors (PR and ER) are most often expressed in endometrial cancer cases, and to correlate this expression with histopathologic features in these cases. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology, Government Medical College, Thrissur, Kerala, India, on 37 cases of endometrial carcinoma. ER and PR expression were assessed and correlated with histopathologic parameters in carcinoma endometrium. Results: 75.6% of the patients were in the 51-70 age range. Grade I endometrioid cancer accounted for 24 (77.42%) of the 31 cases, grade II for 5 (16.13%) and grade III for 2 (6.45%). 19 (51.4%) of cases had ER positivity and 21 (56.8%) had PR positivity. While all grade III tumours were PR and ER negative, grade I tumours had 70.83% and 79.17% ER and PR positivity, respectively. While ER expression did not correlate negatively with grade (p-value=0.076), PR expression did (p-value=0.043). In 29.73% of patients, lymphocytic infiltrates were seen, and they had a strong correlation with the expression of ER and PR. All cases of papillary serous carcinomas (100%), mucinous carcinomas (100%), and clear cell carcinomas (100%), showed ER negative. Hormone receptor status did not significantly correlate with FIGO (The International Federation of Gynecology and Obstetrics) stage, lymphovascular emboli, or myometrial invasion. Conclusion: Most of the endometrioid endometrial carcinomas showed ER and PR positivity, while all of the non endometrioid endometrial carcinomas were negative for both ER and PR. ER and PR were positive in most of the grade I tumours, whereas in the high-grade tumours, they were often negative. Immunoreactivity for PR had a stronger association with tumour grade, when compared to ER.