title: Asynchronous glands in secretory pattern endometrium: clinical associations and immunohistological changes.
abstract: OBJECTIVE
  The significance and pathogenesis of irregular or asynchronous maturation within endometrial glands remains uncertain. The aim of this study was to investigate differences in epithelial hormone receptor immunoreactivity and stromal cell calretinin, CD34 and p16 expression in morphologically normal secretory endometrium and in asynchronous (non-secretory) endometrial glands (AEGs).
  
  
  RESULTS
  Nineteen consecutive endometrial specimens showing AEGs were examined. The mean age of the patients was 42.8 years, and the most common presenting symptom was menorrhagia. Immunohistological expression of oestrogen receptor (ER) α, of ERβ and of progesterone receptor (PR) were compared in normal secretory glands and in AEGs. Stromal cell expression of calretinin, CD34 and p16 was also investigated. In contrast to normal secretory glands, the epithelial cells lining AEGs were usually ERα/PR-positive and showed significantly increased ERβ expression. Altered calretinin and CD34 expression within functional layer stromal cells was seen in five and two cases, respectively, but there were no differences in stromal cell immunoreactivity around AEGs.
  
  
  CONCLUSIONS
  The most common clinical symptom associated with AEGs in this study was menorrhagia. Aberrant hormone receptor expression in AEGs suggests a localized, possibly clonal, defect in epithelial maturation. There were no immunophenotypic changes to suggest that AEGs are related to a primary endometrial stromal deficiency.
authors.affiliation: Department of Histopathology, King Edward Memorial Hospital, Perth, WA, Australia.|School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia.
authors.forename: Colin J R
authors.initials: CJ
authors.lastname: Stewart
authors.affiliation: Centre for Applied Statistics, University of Western Australia, Perth, WA, Australia.|Department of Research, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Chrianna
authors.initials: C
authors.lastname: Bharat
authors.affiliation: Hollywood Hospital, Nedlands, Perth, WA, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Leake
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D001706:Biopsy; D064032:Calbindin 2 / Q000378:metabolism*; D004717:Endometrium / Q000378:metabolism* / Q000473:pathology; D047628:Estrogen Receptor alpha / Q000378:metabolism*; D047629:Estrogen Receptor beta / Q000378:metabolism*; D005260:Female; D019942:Genes, p16 / Q000502:physiology; D006801:Humans; D008595:Menorrhagia / Q000209:etiology / Q000378:metabolism; D008875:Middle Aged; D011980:Receptors, Progesterone / Q000378:metabolism*
chemical_list: D018952:Antigens, CD34; C576764:CALB2 protein, human; D064032:Calbindin 2; D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011980:Receptors, Progesterone
keywords: CD34; asynchronous gland; calretinin; endometrium; hormone receptor; immunohistochemistry; maturation; p16