Biomarkers of progestin therapy resistance and endometrial hyperplasia progression

Am J Obstet Gynecol. 2012 Jul;207(1):36.e1-8. doi: 10.1016/j.ajog.2012.05.012. Epub 2012 May 16.

Abstract

Objective: We sought to identify biomarkers associated with progestin therapy resistance and persistence/progression of endometrial hyperplasia.

Study design: We performed a nested case-control study among women with complex (n = 73) and atypical (n = 41) hyperplasia treated with oral progestin, followed up 2-6 months for persistence/progression. We evaluated index endometrial protein expression for progesterone receptor isoform A, progesterone receptor isoform B (PRB), PTEN, Pax-2, and Bcl-2. Odds ratios and 95% confidence intervals (CIs) were estimated.

Results: Among women with atypical hyperplasia, high PRB expression was associated with 90% decreased risk of persistence/progression (95% CI, 0.01-0.8). High expression of progesterone receptor A and PRB suggested decreased risk of persistence/progression (odds ratio, 0.1; 95% CI, 0.02-1.0). These findings were not observed among women with complex hyperplasia. No associations were found with PTEN, Pax-2, and Bcl-2 protein expression.

Conclusion: PRB expression shows promise as a biomarker of progestin response. Further research is warranted to understand how PRB expression may guide treatment decisions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Biomarkers / metabolism
  • Case-Control Studies
  • Disease Progression
  • Endometrial Hyperplasia / drug therapy*
  • Endometrial Hyperplasia / metabolism
  • Endometrial Hyperplasia / pathology
  • Endometrium / metabolism
  • Endometrium / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Odds Ratio
  • PAX2 Transcription Factor / metabolism*
  • PTEN Phosphohydrolase / metabolism*
  • Progestins / therapeutic use*
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*
  • Receptors, Progesterone / metabolism*
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Biomarkers
  • PAX2 Transcription Factor
  • PAX2 protein, human
  • Progestins
  • Proto-Oncogene Proteins c-bcl-2
  • Receptors, Progesterone
  • progesterone receptor A
  • progesterone receptor B
  • PTEN Phosphohydrolase
  • PTEN protein, human