Immunohistochemical analysis of estrogen and progesterone receptors expression in gingival lesions

Abstract EN

Background : Some lesions in the oral cavity and mostly on the gingival have predominant predilection towards females.

Such lesions occur most commonly in the first fourth decades of life when changes in sex hormones levels in the blood are obvious , for example pyogenic granuloma is a tumor like lesion of oral cavity that is considered to be non-neoplastic in nature and arises in response to local irritation.

The present study aimed to evaluate the role of female sex steroid hormones in pathogenesis of pyogenic granuloma (P.G) , peripheral giant cell granuloma (P.G.C.G), and peripheral ossifying fibroma (P.O.F) , on human gingival as a target organ .

Materials and Methods : This Study conducted on 40 case of reactive gingival lesions as a study group and 10 specimens of normal gingival tissue as a control group.

These samples are collected to evaluate the expression of estrogen and progesterone by using immuinohistochemistry .The study group included 15 case of P.G, 13 case of P.G.C.G and 12 case of P.O.F.

An immunohistochemical staining with estrogen monoclonal antibody marker and anti progesterone monoclonal antibody were performed.

All tests were carried out on 4μm sections from formalin fixed paraffin embedded tissues.

Results : The age range of the subject in this study is 10 -59 years and the male to female ratio was 14/26 (1:1.85) for study group while it was 5/5 (1:1) for control group .

The cases have been already diagnosed, three subtypes of gingival lesions were studies .

These include 15 case of P.G (37.5 %), 13 case of P.G.C.G (32.5 %) and 12 case of P.O.F (30 %) After immunohistochemical staining, all subjects in the control group showed negative expression for estrogen and progesterone, while in the study group, 11 estrogen and progesterone receptors were detected.

Eight of these receptors were ER and three were PR .

Estrogen was detected in the three lesions while progesterone was not detected in P.G.

In order of decreasing frequency, the ERs and PRs were found in PG.C.G (n=6), P.G (n=3) and P.O.F.

(n=2).

The expression of these receptors was distributed in three site including epithelial, inflammatory and mesencymal cells.

Progesterone expression was much less than that’s of estrogen in both quantity (proportion of positive cell) and intensity.

Significant difference for expression of these receptors was found between the three types of the lesions.

This study showed significant difference in ERs expression between males and females.

The positivity of ERs receptor in females was more than males.

On the other hand no significant difference for PRs expression was found between males and females.

Conclusions : Estrogen and progesterone may play a role in the pathogenesis of the three oral lesions , P.G , P.G.C.G and P.O.F by mechanism other than hormone receptor interaction , such mechanism may attributed to levels of circulating hormones .Increase levels of these hormone may induce the release of inflammatory mediators from mast cell and stimulate the proliferation of fibroblast.