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Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):131-137
DOI 10.1590/S0100-72032009000300005
PURPOSE: to evaluate the effects of tamoxifen on the expression of TGF-β and p27 proteins in polyps and adjacent endometrium of women after menopause. METHODS: prospective study with 30 post-menopausal women with diagnosis of breast cancer, taking tamoxifen (20 mg/day), presenting diagnosis of suspect endometrial polyps through transvaginal ultrasonography, and submitted to diagnostic and surgical hysterectomy to withdraw the polyps and adjacent endometrium. A immunohistochemical study has been done to verify the expression of the TGF-β and p27 proteins in the polyps and adjacent endometrium. These proteins' quantification has been done by morphometry. RESULTS: the patients' average age was 61.7 years old; their average age at the menopause onset was 49.5; and the average of using tamoxifen was 25.3 months. The average concentration of positive cells for TGF-β protein in the glandular and stroma polyp epithelium was 62.6±4.5 cells/mm². For the p27, in the glandular polyp epithelium, it was 24.2±18.6 cells/mm² and for the stroma, 19.2±15.2 cells/mm². There was no significant difference between the expression of TGF-β and p27 in the glandular epithelial form the polyps and the adjacent endometrium. The expression of proteins in the polyp and adjacent endometrium with its respective glandular and stroma epithelium showed a significant difference for the p27 protein (r=0.9, p<0.05). CONCLUSIONS: we have concluded that the TGF-β expression is not related to the effect of tamoxifen on the growing of endometrial polyps, but the absence of polyps' malignization by tamoxifen may be explained by the high expression of p27 protein in its glandular epithelium.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):131-137
DOI 10.1590/S0100-72032009000300005
PURPOSE: to evaluate the effects of tamoxifen on the expression of TGF-β and p27 proteins in polyps and adjacent endometrium of women after menopause. METHODS: prospective study with 30 post-menopausal women with diagnosis of breast cancer, taking tamoxifen (20 mg/day), presenting diagnosis of suspect endometrial polyps through transvaginal ultrasonography, and submitted to diagnostic and surgical hysterectomy to withdraw the polyps and adjacent endometrium. A immunohistochemical study has been done to verify the expression of the TGF-β and p27 proteins in the polyps and adjacent endometrium. These proteins' quantification has been done by morphometry. RESULTS: the patients' average age was 61.7 years old; their average age at the menopause onset was 49.5; and the average of using tamoxifen was 25.3 months. The average concentration of positive cells for TGF-β protein in the glandular and stroma polyp epithelium was 62.6±4.5 cells/mm². For the p27, in the glandular polyp epithelium, it was 24.2±18.6 cells/mm² and for the stroma, 19.2±15.2 cells/mm². There was no significant difference between the expression of TGF-β and p27 in the glandular epithelial form the polyps and the adjacent endometrium. The expression of proteins in the polyp and adjacent endometrium with its respective glandular and stroma epithelium showed a significant difference for the p27 protein (r=0.9, p<0.05). CONCLUSIONS: we have concluded that the TGF-β expression is not related to the effect of tamoxifen on the growing of endometrial polyps, but the absence of polyps' malignization by tamoxifen may be explained by the high expression of p27 protein in its glandular epithelium.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):473-478
DOI 10.1590/S0100-72032006000800006
PURPOSE: to verify the effects of intrauterine levonorgestrel device (IUD) in women with adenomyosis, with implantation failure in previous in vitro fertilization (IVF) cycles. METHODS: eighty infertile women with ages up to 38 years, who had adenomyosis diagnosed by ultrasonography and MRI were selected. All the women presented antecedents of one or more tormer IVF attempts without success due to implantation failure. The women were subdivided into IUD Group, composed of 40 women with an IUD that released 20 µg of levonorgestrel/day during six months, preceding a new IVF cycle, and IVF Group, also composed of 40 women, who were directly submitted to a new IVF cycle without previous adenomyosis treatment. In the IUD Group the uterine volume, thickness and hypersignal foci of the junctional zone were assessed before and after treatment, as well as the pregnancy rates in the new IVF cycle, compared to the data obtained with the IVF Group. Statistical analyses were performed adopting the significance level of 5% (p<0,05), using the Mann-Whitney and Sudent's t tests. RESULTS: after treatment, there was a reduction of 77.7% in the cases of focal adenomyosis, in addition to a significant reduction of the uterine volume and of the mean thickness of the junctional zone from 128.8 to 93.6 ml and from 12.3 to 11.3 mm, respectively. In the IUD Group, pregnancy rate reached 30%, which was higher than, but not significantly different from that of the IVF group, which was 17.5%. CONCLUSION: the use of an IUD with levonorgestrel may be administered prior to IVF cycles in patients with adenomyosis who suffered previous implantation failure.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):473-478
DOI 10.1590/S0100-72032006000800006
PURPOSE: to verify the effects of intrauterine levonorgestrel device (IUD) in women with adenomyosis, with implantation failure in previous in vitro fertilization (IVF) cycles. METHODS: eighty infertile women with ages up to 38 years, who had adenomyosis diagnosed by ultrasonography and MRI were selected. All the women presented antecedents of one or more tormer IVF attempts without success due to implantation failure. The women were subdivided into IUD Group, composed of 40 women with an IUD that released 20 µg of levonorgestrel/day during six months, preceding a new IVF cycle, and IVF Group, also composed of 40 women, who were directly submitted to a new IVF cycle without previous adenomyosis treatment. In the IUD Group the uterine volume, thickness and hypersignal foci of the junctional zone were assessed before and after treatment, as well as the pregnancy rates in the new IVF cycle, compared to the data obtained with the IVF Group. Statistical analyses were performed adopting the significance level of 5% (p<0,05), using the Mann-Whitney and Sudent's t tests. RESULTS: after treatment, there was a reduction of 77.7% in the cases of focal adenomyosis, in addition to a significant reduction of the uterine volume and of the mean thickness of the junctional zone from 128.8 to 93.6 ml and from 12.3 to 11.3 mm, respectively. In the IUD Group, pregnancy rate reached 30%, which was higher than, but not significantly different from that of the IVF group, which was 17.5%. CONCLUSION: the use of an IUD with levonorgestrel may be administered prior to IVF cycles in patients with adenomyosis who suffered previous implantation failure.