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Anyone Have Info./Experience With Regard to PR Receptors?

Alexandria
Posts: 3
Joined: Jan 2012

I am just wondering if any of you have any information and have had experience in finding out on your pathology report about the levels of your Progesterone Receptors?

I have read numerous articles in the medical journals that claim this is the single most important prognostic factor besides stage and that high PR is prognostically very good.

I got my PR levels read and I have very low amounts -- "focally positive," which, I believe, amounts to weak.

Anyone out there have low PR and is a long-time survivor.

I just got diagnosed in November and am facing the years ahead with uncertainly, and the low PR levels have me worried.

I am Grade 1, Stage 2 Endometroid Adenocarcinoma, though my biopsy, unfortunately, showed a clear-cell component of some kind. I am doing 3 cycles of Carbo/Taxol and Vaginal brachytherapy as a result.

Any one with any news about or experience with PR receptors? I would like to learn more about how this research translates into the experience of cancer survivors.

Thanks,

Alexandria

california_artist
Posts: 850
Joined: Jan 2009

Found this on google. It might help you clarify things. Were it me, I would call the lab and ask for their definintion in using the focally positive. I have called my hospitals lab and they were very willing to specify what the terms meant.

www.ncbi.nlm.nih.gov/pubmed/12733118

Benign cystic mesothelioma of the peritoneum: a clinicopathologic study of 17 cases and immunohistochemical analysis of estrogen and progesterone receptor status.
Sawh RN, Malpica A, Deavers MT, Liu J, Silva EG.
Source
Division of Pathology and Laboratory Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Abstract
Benign cystic mesothelioma (BCM) is an uncommon lesion of the peritoneum occurring predominantly in women of reproductive age. Although most patients are managed by surgical resection, a reported high incidence of cyst recurrence has led to the use of hormonal therapy in isolated cases in an attempt to control cyst size and relieve local symptoms. To date, the estrogen receptor (ER) and progesterone receptor (PR) status of BCM has not been evaluated. Here we present our experience with 17 cases (13 women, 4 men) of BCM seen over a 19-year period, including an immunohistochemical analysis of ER and PR status in 14 cases. All lesions showed typical morphological features of BCM, and calretinin immunostaining was positive in 14 of 14 cases.
Five patients experienced either 1 or 2 tumor recurrences, and no patients died of disease.

One case was diffusely positive for ER only, 1 case was focally positive for PR only, and 1 case was focally positive for both ER and PR. Although immunohistochemical detection of female sex hormone receptors in BCM is uncommon, the focal presence of ER and/or PR in some lesions does provide weak biologic support for the use of hormonal manipulation as a therapeutic option. Hum Pathol 34:369-374.

This is not uterine but does refer to difuse and focal positivity.

---

This is another instance where the terms are used. But I would try to get a specific definition from your lab to be certain what you are dealing with.

www.ncbi.nlm.nih.gov/pubmed/17885486

Estrogen receptor alpha and progesterone receptor expression in ovarian adult granulosa cell tumors and Sertoli-Leydig cell tumors.
Farinola MA, Gown AM, Judson K, Ronnett BM, Barry TS, Movahedi-Lankarani S, Vang R.
Source
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, USA.
Abstract
The biologic role that estrogen receptor (ER) and progesterone receptor (PR) play in ovarian sex cord-stromal tumors is poorly understood. Furthermore, immunohistochemical data on these hormone receptors in this group of neoplasms are limited and conflicting, with many reports suggesting that expression of ERalpha and/or PR is either infrequent or present at low levels in granulosa and Sertoli cell tumors. Immunohistochemical staining for ERalpha and PR was performed in 69 ovarian sex cord-stromal tumors: 41 adult granulosa cell tumors and 28 Sertoli-Leydig cell tumors. Extent of expression was scored based on the percentage of positive cells: 0, 5% or less; 1+, 6% to 25%; 2+, 26% to 50%; 3+, 51% to 75%; and 4+, 76% to 100%. Estrogen receptor alpha and PR were frequently expressed in adult granulosa cell tumors (66% and 98%, respectively) and Sertoli-Leydig cell tumors (79% and 86%, respectively). Diffuse (3+ or 4+) expression of PR was more common in adult granulosa cell tumors (68% vs. 36%; P = 0.013), whereas diffuse (3+ or 4+) expression of ERalpha was more frequent in Sertoli-Leydig cell tumors (50% vs. 20%; P = 0.010). In cases positive for both markers, adult granulosa cell tumors exhibited a focal (1+ or 2+) ERalpha/diffuse (3+ or 4+) PR coordinate profile more commonly than Sertoli-Leydig cell tumors (52% vs. 18%; P = 0.02), whereas Sertoli-Leydig cell tumors displayed a diffuse (3+ or 4+) ERalpha/focal (1+ or 2+) PR profile more frequently than adult granulosa cell tumors (36% vs. 0%; P = 0.0007). We conclude that expression of hormone receptors (based only on frequency of immunostaining) does not allow for distinction from other tumors in the differential diagnosis that are known to be frequently positive for ERalpha and PR such as endometrioid neoplasms. Most adult granulosa cell tumors and Sertoli-Leydig cell tumors share overlapping patterns of expression of ERalpha and PR with each other, but a subset of cases in each tumor category exhibits unique ERalpha/PR immunoprofiles (eg, focal ERalpha/diffuse PR in adult granulosa cell tumors and diffuse ERalpha/focal PR in Sertoli-Leydig cell tumors). These patterns of expression of ERalpha and PR may aid our understanding of the biologic differences between granulosa and Sertoli cell tumors.

Does appear to be as you thought though.

typed --diffuse vs focally positive pr receptors --in google to get these examples.

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

You mentioned years of uncertainty. I agree. But we all have this. There are no guarantees for any of us whether we have PR+ or PR-.

I am mostly PR-. My doc told me that hormone treatment would not be option for me but he never said it would lower my odds. Cancer is a crap shoot as many have said. But when I get anxious about stats, my doc reminds me that life is a crap shoot - "no guarantees that either of us will get home alive today!!!"

For you and I, let's try to live in the moment and not years from now.

Hang in there. All the best, Mary Ann

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I couldn't have said it any better then what you posted. Gosh we're guaranteed a life but no one knows how long and what health issues, etc, we'll encounter. All of this is basically a crap shoot~

I try to enjoy each day and do what I think is best to help fight the cancer beast. In the end, no guarantees, therefore, I'm accepting to enjoy each day!!

Peace to all~
Jan

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