Analysis of differential genetic expression in endometrial polyps of postmenopausal women

Abstract

Objectives: To evaluate the expression of four genetic markers (PTEN, BCL2, MLH1, and CTNNB1), linked to endometrial carcinogenesis, in endometrial polyps of patients with and without postmenopausal bleeding in order to determine whether symptomatic endometrial polyps have a genetic phenotype similar to that of endometrial cancer.

Methods: Samples were obtained hysteroscopically from endometrial polyps of postmenopausal patients, and the expression of genetic markers involved in the pathogenesis of endometrial cancer (PTEN, BCL2, MLH1, and CTNNB1) was analyzed. The expression of these markers was then compared between patients with and without symptoms, which was characterized as postmenopausal bleeding. Other clinical characteristics of the patients, such as duration of menopause, polyp size, presence of systemic hypertension, diabetes mellitus, and smoking habits were also analyzed.

Results: Samples from a total of 60 patients were obtained, as calculated for a test power of 0.80. No statistical differences (p > 0.05) were observed between the two groups concerning the expression of the studied endometrial cancer risk factor genes, or with regard to the clinical aspects evaluated.

Conclusion: The study found no evidence that symptomatic endometrial polyps have a similar phenotype to type 1 endometrial cancer; further studies are needed in order to establish whether endometrial polyps are in fact true cancer precursors, or simply raise cancer incidence due to a detection bias.

Keywords:

• Endometrial disease
• polyps
• postmenopausal
• endometrial cancer
• gene expression profile

Acknowledgements

We thank the Foundation of Support to Research of the state of São Paulo (Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP) for its financial support.

Conflict of interest

The authors declare that they have no conflict of interest.

Source of funding

This work was supported by FAPESP (Foundation of Support to Research of the state of São Paulo [Grant number 2014/20873-1]).