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Progesterone Receptor Status Predicts Response to Progestin Therapy in Endometriosis
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Journal Article
Progesterone Receptor Status Predicts Response to Progestin Therapy in Endometriosis
2018
Overview
Progestin-based therapy is the first-line treatment for managing endometriosis-associated pain. However, response to progestins is currently variable and unpredictable. Predictive markers for response to progestin-based therapy would allow for a personalized approach to endometriosis treatment.
We hypothesize that progesterone receptor (PR) levels in endometriotic lesions determine response to progestin-based therapy.
Retrospective cohort study.
Academic center.
Fifty-two subjects with histologically confirmed endometriosis and a previous documented response to hormonal therapy were included.
Immunohistochemistry was performed on sections of endometriotic lesions using a rabbit polyclonal IgG for detection of PR-A/B.
The Histo (H)-score was used for quantifying PR status. Response to progestin-based therapies was determined from review of the electronic medical record.
H-score was higher in responders compared with nonresponders. Subjects were categorized into three groups: high (H-score > 80, n = 7), medium (H-score 6 to 80, n = 28), and low (H-score ≤ 5, n = 17) PR status. The threshold of PR > 80 was associated with a 100% positive predictive value. The threshold of PR < 5 was associated with a 94% negative predictive value.
PR status is strongly associated with response to progestin-based therapy. Receptor status in endometriosis could be used to tailor hormonal-based regimens after surgery, and negate trialing progestin-based therapy to determine resistance. Ascertainment of PR status may allow for a novel, targeted, precision-based approach to treating endometriosis.
Publisher
Copyright Oxford University Press,Oxford University Press,Endocrine Society
