Clinicopathological correlation of endometrial hyperplasias with progesterone receptor expression in DUB

Abstract

BACKGROUND: Progesterone receptor (PR) is widely studied for its role in diagnosis and treatment of endometrial hyperplasia. Dysfunctional uterine bleeding (DUB) is a common gynecological presentation of these precancerous lesions. AIM: To study PR immunoreactivity of endometrial hyperplasias diagnosed in DUB patients and its association with other parameters such as patient age, parity, and presenting symptoms. MATERIALS AND METHODS: The study included endometrial samples of 40 DUB patients diagnosed as endometrial hyperplasia in the Department of Pathology, J.J.M.M.C, Davangere, between June 2019 and November 2020. PR expression was assessed using Allred score. Categorical data were represented as frequencies and percentages, whereas Chi-square test was used to know associations between variables with P < 0.05 which was considered statistically significant. RESULTS: The most common presenting complaint was menorrhagia (26), followed by dysmenorrhea (6), polymenorrhea (4), metrorrhagia (3), and postmenopausal bleeding (1). Most patients belonged to the age group of 40–49 years (52.5%), which included perimenopausal age followed by premenopausal 30–39 years (30%). There was a strong association between parity and PR score (P < 0.001) indicating an increase in the score with parity. PR expression was variable from very poor immunoreactivity (Allred score 3) to rich immunoreactivity (Allred score 7 and 8). This variability was seen with endometrial hyperplasia without atypia. Rich immunoreactivity was also seen in the endometrial hyperplasia with atypia but comparatively lesser than compared to without atypia. CONCLUSION: Variability of PR expression of endometrial hyperplasia points toward other factors that may have influenced this variability, which is increased with parity.

Keywords

• dysfunctional uterine bleeding
• endometrial hyperplasia
• progesterone receptor