Abstract | STUDY OBJECTIVE: DESIGN: Retrospective cohort study. SETTING: University of Naples Federico II, Naples, Italy. PATIENTS: Thirty-six consecutive premenopausal women <45 years of age with AEH (n = 29) or EEC (n = 7) conservatively treated from January 2007 to June 2018 were retrospectively assessed. INTERVENTIONS: All patients had been treated with hysteroscopic resection plus levonorgestrel-releasing intrauterine device insertion and followed for at least 1 year. The immunohistochemical expression of PRB was separately assessed in the glands and stroma of the lesion and dichotomized as "weak" or "normal." MEASUREMENT AND MAIN RESULTS: The treatment outcomes considered were (1) treatment failure (i.e., a combined outcome including no regression or recurrence); (2) no regression; and (3) recurrence. The predictive accuracy of PRB immunohistochemistry was assessed by calculating sensitivity (SE), specificity (SP), and area under the receiver operating characteristic curve (AUC). A weak glandular PRB expression showed SE = 70%, SP = 77%, and AUC = 0.74 for treatment failure; SE = 66.7%, SP = 70%, and AUC = 0.68 for no regression; and SE = 75%, SP = 68.8%, and AUC = 0.72 for recurrence. A weak stromal PRB expression showed SE = 100%, SP = 53.8%, and AUC = 0.77 for treatment failure; SE = 100%, SP = 46.7%, and AUC = 0.73 for no regression; and SE = 100%, SP = 43.8%, and AUC = 0.72 for recurrence. CONCLUSION: A weak stromal PRB expression is a highly sensitive predictive marker of both no response and recurrence of AEH and EEC conservatively treated.
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Authors | Antonio Raffone, Antonio Travaglino, Francesco Maria Zullo, Annarita Gencarelli, Mariacarolina Micheli, Sergio Miranda, Pasquale De Franciscis, Luigi Insabato, Attilio Di Spiezio Sardo, Fulvio Zullo, Giuseppe Bifulco |
Journal | Journal of minimally invasive gynecology
(J Minim Invasive Gynecol)
Vol. 28
Issue 6
Pg. 1244-1253
(06 2021)
ISSN: 1553-4669 [Electronic] United States |
PMID | 33122144
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 AAGL. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Receptors, Progesterone
- progesterone receptor B
- Levonorgestrel
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Topics |
- Endometrial Hyperplasia
(surgery)
- Endometrial Neoplasms
(surgery)
- Female
- Humans
- Intrauterine Devices, Medicated
- Levonorgestrel
(therapeutic use)
- Neoplasm Recurrence, Local
- Receptors, Progesterone
- Retrospective Studies
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