ER, PR and Ki-67 expression status in granulomatous and  chronic non-specific endometritis.
OBJECTIVE
To study the changes in the histological pattern, distribution and intensity of sex steroid receptors (estrogen and progesterone) and cell proliferation by Ki-67 expression by semi-quantitative scores in granulomatous and chronic non-specific endometritis in the premenstrual phase.


METHODS
A retrospective study was conducted on 20 cases of granulomatous endometritis, 10 of chronic non-specific endometritis and 30 age matched (2 years) controls with no endometrial lesions. Morphological changes were noted on histological examination and semi-quantitative scoring of Estrogen Receptor (ER), Progesterone Receptor (PR) and Ki-67 expression was done by immunohistochemistry.


RESULTS
There was significantly higher ER, PR and Ki-67 expression in endometrial glandular and stromal cells in inflamed endometria as compared with the controls (all P-values < 0.02) regardless of the character of the inflammation. The cases with morphology not conforming to the secretory phase at which biopsy was taken had significantly higher ER, PR and Ki-67 expression in both endometrial and stromal cells indicating a lag in the endometrial maturation (all P-values < 0.02). Interestingly, all parameters except PR expression in glandular cells had a significantly higher expression even in cases with secretory morphology indicating disturbances in local milieu.


CONCLUSIONS
Endometrial inflammation interferes with local expression of ER, PR and Ki-67. This may contribute to infertility regardless of other factors and other endometrial dysfunctional states.
Mishra
Kiran
K
Department of Pathology, University College of Medical Sciences, Delhi, India. kmis29@hotmail.com
Wadhwa
Neelam
N
Guleria
Kiran
K
Agarwal
Sarla
S
D000328:Adult; D002908:Chronic Disease; D004716:Endometritis / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D004717:Endometrium / Q000737:chemistry / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007247:Infertility, Female / Q000209:etiology; D019394:Ki-67 Antigen / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012189:Retrospective Studies; D017154:Stromal Cells / Q000737:chemistry / Q000473:pathology
D019394:Ki-67 Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone