Kankaya, DuyguÖzakıncı, Hilal2022-08-242022-08-242015http://hdl.handle.net/20.500.12575/83371: cancers subdivided into two groups according the pathogenesis and biological behavior. Type I cancers occur at the background of hyperplasia. They are estrogen dependent, more common, and have better prognosis than type II cancers. α is the first, β is the second defined estrogen receptor. Recently, a membranous estrogen receptor, GPR30 was discovered. ERα and ERβ have function in the nucleus and have genomic effects. ERα and GPR30 have an important role in type I endometrial carcinogenesis but ERβ's effects are indefinite. Some studies showed ERβ has proliferative, other studies showed ERβ has antiproliferative effects on the endometrium. GPR30 has an important role in endometrial lesions especially TAM related ones. GPR30 antagonists can prevent proliferative effects of TAM in the endometrium. In this study, our aim is to evaluate immunohistochemically estrogen receptors' expression, through the endometrial neoplasia spectrum. Normal endometrium, hyperplasia without atypia, atypical hyperplasia, endometrioid carcinoma, TAM related and unrelated endometrial polyp groups are included in the study. In the carcinoma group, the relationship between receptor expression status and clinicopathological features was investigated. Additionally receptor expression status of the TAM related and unrelated endometrial polyps were compared. MATERIAL AND METHOD: Hysterectomy and endometrial biopsy specimens searched in the computerized archive records. 15 proliferative, 15 secretuary endometrium; 22 hyperplasia without atypia, 23 atypical hyperplasia, 30 endometrioid carcinoma, 15 TAM related and 15 TAM unrelated endometrial polyps, which had appropriate tissue for immunohistochemical analyses, were included in the study. H&E stained slides were reevaluated and patients' age; specimen type; endometrial thickness in the hysterectomy specimens; tumour diameter, grade, lymph node metastasis status, FIGO stage, metastasis and servical involvement status in the carcinomas; tissue volume in the probe currettage specimens were noted. ERα, ERβ and GPR30 expression percentage and intensity were evaluated; immunoreactivity score (IRS) was calculated. The statistical analyses performed in the SPSS for Windows 15 programme, and p value equal or lower than 0.05 accepted statistically significant. RESULTS: The mean patient age was 52. The mean age of endometrioid carcinoma group was higher than other groups (p<0.05). 33% of specimens were hysterectomy and 67% of specimens were biopsy material. The mean tumour diameter was 32 mm. In the carcinoma group, the percentage of the tumour grade I,II and III were 20%, 53%, and 27% respectively. 12% of tumours had lymph node metastasis, 7% of tumours had cervical stromal invasion. 65% of tumours invaded one half or more of the myometrium. The percentage of advanced staged tumours was 24%. The mean of the duration of TAM treatment was 2.3 year. The expression percentage of ERα, ERβ and GPR30 was 99%, 82 %, 61% in all samples, respectively. ERα (p<0.05) and GPR30 (p>0.05) expressions were lower in the secretuary phase than proliferative phase, ERβ expressions were similar in the proliferative and secretuary phases. ERα and ERβ expressions were similar in normal endometrium and carcinoma groups, but GPR30 expression was higher in endometrial carcinoma group than secretuary endometrium (p<0.05). GPR30 expression increased (p>0.05) progressively in the endometrial hyperplasia - carcinoma pathway. There was no correlation between clinicopathological features and ER expressions in endometrial carcinoma group. All of the TAM related polyps were benign, there was no malignancy. The expression percentage of the ERα, ERβ and GPR30 were similar in TAM related and unrelated polyps. When TAM related polyps subdivided into two groups according to the duration of treatment (less than 3 years / 3 years or more) and compared with TAM unrelated polyps; GPR30 expressions were higher (p>0.05), ERβ expressions were lower (p=0.02) in the TAM related polyp group, which had the duration of treatment was 3 year and above, than other polyp groups. Our study is the first study that investigate the GPR30 expression in endometrial hyperplasia - carcinoma pathway. Even tough statistically insignificant, increasing of GPR30 expression correlated with the duration of TAM therapy, this result can support that GPR30 plays a role in TAM related endometrial lesions. Also TAM can prevent the antiproliferative effect of ERβ, by decreasing the expression of this receptor.trGPR30AlfaMedicalThesis