Publication: Assessment of morphological changes and steroid receptors in the uteri of postmenopausal women
Authors
Teresiński, Leszek ; Sipak, Olimpia ; Rył, Aleksandra ; Masiuk, Marek ; Rotter, Iwona ; Ratajczak, Weronika ; Łazowska, Malwina ; Słomczyńska, Maria ; Marchlewicz, Mariola ; Karakiewicz, Beata ; Kram, Andrzej ; Laszczyńska, Maria
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Publisher
Universidad de Murcia. Departamento de Biología Celular e Histología
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DOI
DOI: 10.14670/HH-18-063
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info:eu-repo/semantics/article
Description
Abstract
Introduction. The morphology of the
endometrium constantly changes in the reproductive
period, depending on the levels of ovarian steroid
hormones, and undergoes atrophic changes during
menopause as a result of their insufficiency. The purpose
of this study was to analyze morphological and
morphometric changes in the mucous and muscle layers
of the uterine wall in postmenopausal women, and to
assess localization and number of cells showing the
expression of steroid hormone receptors, namely
estrogen receptor α (ER-α), progesterone receptor (PR),
and androgen receptor (AR) in glandular epithelial cells
and smooth muscle cells in particular groups of women.
Material and methods. The study material consisted
of uterine specimens sectioned across the full thickness
of the uterine wall, and embedded in 164 paraffin blocks.
The specimens came from women without menopausal
hormone therapy (MHT) operated due to reproductive
organ prolapse or uterine myomas. The material was
divided into four groups depending on the time interval
from menopause to surgery: group I - from 1 to 5 years
after menopause, group II - from 6 to 10 years after
menopause, group III - more than 11 years after
menopause, and group IV - women over 70 years of age.
The sections were stained by standard HE, Masson’s
trichrome, and immunohistochemical methods (ERα,
PR, AR). Quantitative assessment of the results was
based on computer image analysis.
Results. Analysis of morphological changes in the
endometrium and myometrium revealed the presence of
increasing regressive changes, such as various types of
atrophy, fibrosis, and calcification, augmented over time
from the last menstruation. Furthermore, endometrial
polyps, foci of endometriosis, and leiomyomas were
observed. Based on the results of morphometric
measurements, a constant decrease in the endometrial
and myometrial thickness was noticed in the studied
groups (I-IV). Significant differences between the
groups were observed in the number of ER-α positive
cells in the myometrium, but not in the endometrial
glandular epithelium. Statistically significant differences
in the number of AR positive cells were detected in the
endometrial epithelium and in the uterine muscle. The
analysis the number of PR positive cells demonstrated
differences between the groups in the endometrial
stroma and the myometrium.
Conclusion. The uterus of postmenopausal woman
undergo major morphological changes (mainly atrophic
lesions in the endometrium and myometrium), leading to
a decline in their morphometric parameters over time
from the last menstruation. Localization and number of
cells showing the expression of steroid receptors: ER-α,
PR, and AR in the uterus of postmenopausal women,
depending on the time interval from the last
menstruation.
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