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The Relationship Among HOXA10, Estrogen Receptor α, Progesterone Receptor, and Progesterone Receptor B Proteins in Rectosigmoid Endometriosis: A Tissue Microarray Study

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Abstract

Background

Very few studies have evaluated the expression of homeobox A10 (HOXA10) and steroid (estrogen and progesterone) receptors exclusively in deep endometriosis. Conclusions drawn from studies evaluating peritoneal and ovarian endometriosis are usually generalized to explain the pathogenesis of the disease as a whole. We aimed to evaluate the expression of HOXA10, estrogen receptor α (ER-α), progesterone receptor (PR), and PR-B in rectosigmoid endometriosis (RE), a typical model of deep disease.

Methods

We used RE samples from 18 consecutive patients to construct tissue microarray blocks. Nine patients each were operated during the proliferative and secretory phases of the menstrual cycle. We quantified the expressions of proteins by immunohistochemistry using the modified Allred score.

Result

The HOXA10 was expressed in the stroma of nodules during the secretory phase in 5 of the 18 patients. Expression of ER-α (in 16 of 18 patients), PR (in 17 of 18 patients), and PR-B (17 of 18 patients) was moderate to strong in the glands and stroma of nodules during both phases. Expression of both PR (P = .023) and PR-B (P = .024) was significantly greater during the secretory phase.

Conclusion

The HOXA10 is expressed in RE, where it likely imparts the de novo identity of endometriotic lesions. The ER-α, PR, and PR-B are strongly expressed in RE, which differs from previous studies investigating peritoneal and ovarian lesions. This suggests different routes of pathogenesis for each of the 3 types of endometriosis.

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Authors and Affiliations

  1. Department of Gynecology, São Paulo University School of Medicine, SEPS 714/914 Bloco D — Edificio Sabin, Salas 209-211, Brasilia, Federal District, 70390-145, Sao Paulo, Brazil

    Alysson Zanatta MD, PhD, Edmund Chada Baracat MD, PhD & Paulo Cesar Serafini MD, PhD

  2. Endometriosis Center, Santa Joana Hospital, Sao Paulo, Brazil

    Ricardo Mendes Alves Pereira MD

  3. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA

    André Monteiro da Rocha DVM, PhD

  4. Department of Molecular and Morphologic Sciences, São Paulo University School of Zootechny and Veterinary Medicine, Sao Paulo, Brazil

    Bruno Cogliati DVM, PhD

  5. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

    Hugh S. Taylor MD, PhD

  6. Department of Gynecology, São Paulo Federal University School of Medicine, Sao Paulo, Brazil

    Eduardo Leme Alves da Motta MD, PhD

Authors
  1. Alysson Zanatta MD, PhD
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  2. Ricardo Mendes Alves Pereira MD
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  3. André Monteiro da Rocha DVM, PhD
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  4. Bruno Cogliati DVM, PhD
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  5. Edmund Chada Baracat MD, PhD
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  6. Hugh S. Taylor MD, PhD
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  7. Eduardo Leme Alves da Motta MD, PhD
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  8. Paulo Cesar Serafini MD, PhD
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Correspondence to Alysson Zanatta MD, PhD.

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Zanatta, A., Pereira, R.M.A., da Rocha, A.M. et al. The Relationship Among HOXA10, Estrogen Receptor α, Progesterone Receptor, and Progesterone Receptor B Proteins in Rectosigmoid Endometriosis: A Tissue Microarray Study. Reprod. Sci. 22, 31–37 (2015). https://doi.org/10.1177/1933719114549846

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  • DOI: https://doi.org/10.1177/1933719114549846

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