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Female Sex Hormone Receptor Profiling in Uterine Adenosarcomas
  1. Jenna Z. Marcus, MD*,
  2. Merieme Klobocista, MD*,,
  3. Rouzan G. Karabakhtsian, MD, PhD,
  4. Eric Prossnitz, PhD§,
  5. Gary L. Goldberg, MD*, and
  6. Gloria S. Huang, MD*,
  1. * Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center;
  2. Albert Einstein Cancer Center and
  3. Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and
  4. § Division of Molecular Medicine and UNM Comprehensive Cancer Center, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM.
  1. Address correspondence and reprint requests to Jenna Z. Marcus, MD, 185 South Orange Ave, Medical School Bldg, E-536, Newark, NJ 07103. E-mail: jzm16{at}njms.rutgers.edu.

Abstract

Objective This study aimed to identify the hormonal receptor status in uterine adenosarcoma (AS) and uterine AS with sarcomatous overgrowth (AS + SO), including those with high-grade histologic features (nuclear pleomorphism, atypical mitoses, necrosis), with or without heterologous elements. Estrogen receptor (ER) status, including estrogen receptor α (ERα), estrogen receptor β (ERβ), and G protein–coupled estrogen receptor (GPER), and progesterone receptor (PgR) status were examined.

Methods From August 2001 to November 2013, 11 patients with histologic diagnosis of uterine AS were identified. Tumor tissue sections were stained for ERα, ERβ, GPER, and PgR and examined both for percentage of overall cells stained and for intensity of staining. Descriptive statistics were calculated using clinicopathologic data abstracted from the medical record.

Results Eight cases of AS and 3 cases of AS with high-grade features were identified. Seven of 8 tumor samples of AS showed strong or moderate intensity immunostaining for ERα; all AS + SO tumor samples showed minimal to no immunoreactivity for ERα. There was a significant decrease in ERα H scores in high-grade tumors when compared with AS (P = 0.01). Lower PgR H scores were observed in high-grade tumors compared with those in AS (P = 0.04). Estrogen receptor β immunostaining was variable, and GPER immunostaining was absent in the majority of tumor samples.

Conclusions Higher expression of ERα and PgR was observed in AS when compared with those with AS + SO and high-grade features. Both tumor subtypes showed similar levels of ERβ and GPER expression, although significant differences in ERβ and GPER expression were not detected. In contrast to our previous findings in uterine carcinosarcoma, ERs ERβ and GPER do not seem to play a significant role in AS in this study.

  • Estrogen receptor α
  • Estrogen receptor β
  • Estrogen receptor status
  • G protein–coupled estrogen receptor
  • Progesterone receptor
  • Uterine adenosarcoma

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Footnotes

  • The authors declare no conflicts of interest.

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