Correlation between estrogen receptor expression and risk of postoperative recurrence in patients with ovarian endometriosis

Objective To explore the correlation between estrogen receptor (ER) and progesterone receptor (PR) expression and the risk of postoperative recurrence in patients with ovarian endometriosis (EMT).

Methods Totally 185 ovarian EMT patients admitted to the obstetrics and gynecology department of Nanyang Zhang Zhongjing Hospital from April 2019 to April 2020 were recruited as research subjects. They all received surgical treatment, and were followed up for 24 months prospectively. They were divided into relapse group and non-relapse group based on their disease status. The general information of the 2 groups were compared, and immunohistochemistry was used to detect the expression of ER and PR in ectopic tissue. Multivariate Logistic regression was used to analyze the factors associated with recurrence, and restricted cubic spline was used to fit the correlation between the expression of ER and PR and the risk of postoperative recurrence in patients with ovarian EMT.

Results After 24 months of follow up, 4 cases were lost to follow-up due to various reasons, and 181 cases were finally included. 41 cases (22.65%) relapsed were classified as relapse group, and the other 140 cases (77.35%) without relapse were classified as non-relapse group. There were significant differences between 2 groups in terms of the percentage of preoperative dysmenorrhea, score of revised classification of American Fertility Society (r-AFS), expression levels of ER and PR(all P < 0.05). Multivariate Logistic regression analysis showed that dysmenorrhea(OR = 2.637, 95% CI: 1.085 - 6.408), high r-AFS score(OR = 1.040, 95% CI: 1.001 - 1.080), high ER expression level(OR = 1.073, 95% CI: 1.029 -1.118)were risk factors (P < 0.05), while high PR expression level (OR = 0.920, 95% CI: 0.880 - 0.962) was a protective factor for postoperative recurrence in patients with ovarian EMT (P < 0.05). The restricted cubic spline showed that ER and PR expression level were not linear correlated with the risk of postoperative recurrence in ovarian EMT patients (P < 0.05).

Conclusion The expression levels of ER and PR are associated with the risk of postoperative recurrence in ovarian EMT patients. High ER expression and low PR expression can increase the risk of postoperative recurrence of ovarian EMT.