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Distribution, frequency, and quantitative analysis of estrogen, progesterone, androgen, and glucocorticoid receptors in human breast cancer.

The distribution and frequency of steroid hormone receptors are described 329 patients with breast cancer. The distribution of each of the steroid hormone receptors is unimodal with a progressive increase in the proportion of patients positive at lower receptor values. Receptor values expressed as fmol/mg cytoplasmic protein are well correlated with values expressed as fmol/mg breast tumor. Estrogen receptor was positive in 53% of the patients; progesterone receptor was positive in 38% of the patients; glucocorticoid receptor was positive in 52% of the patients; and androgen receptor was positive in 31% of the patients. The type of tissue assayed did not affect steroid hormone receptor positivity. For primary tumors, there was no correlation between steroid hormone receptor positivity and location of the tumor in the breast, size of the tumor, or extent of the disease. Each of the steroid hormone receptors was positively associated with each of the other steroid hormone receptors. Estrogen receptor was correlated with menopausal status and axillary nodal status, but these correlations did not exist for the other steroid hormone receptors. Estrogen receptor was not correlated with age after adjustment for menopausal status. The other steroid hormone receptors were not correlated with age.

Adult↗

Steroid receptors in normal, hyperplastic and malignant human endometria.

Oestrogen and progestin receptors are present in the cytosol and nuclear compartments of normal human endometrium, partly associated with their endogenous ligand hormones. Receptor concentrations fluctuate in relation to the menstrual cycle. Hyperplastic endometrium tends to contain high concentrations of cytosol progestin receptor, whereas the levels of cytosol and nuclear progestin receptors in endometrial adenocarcinoma are lower than in non-neoplastic endometrium. The receptor levels seem to decline with decreasing differentiation of the tumour. Progestin treatment extending over several weeks decreases cellular oestrogen and progestin receptor content in both hyperplastic and malignant endometria. Information based on small patient series suggests that patients suffering from advanced or recurrent endometrial carcinoma and having significant concentrations of both receptors in the tumour tend to have a more indolent clinical course than patients with absent or low tumour receptors. Patients whose lesions are progestin receptor-rich more frequently respond to progestin administration than those with receptor-poor tumours. In contrast, patients with advanced or recurrent disease after progestin treatment and with low tumour oestrogen and progestin receptor concentrations respond more often to combination cytotoxic chemotherapy than patients with higher tumour receptor levels. More data are needed about the clinical correlates of receptor determinations in human endometrial carcinoma to confirm these encouraging preliminary results, before the clinical significance of the determinations can be settled. since there are marked differences in the receptor concentrations reported by various investigators, possibly for methodological reasons, comparison of receptor data and treatment results from different groups is sometimes very difficult.

Breast Neoplasms↗

The correlation of estrogen and progesterone receptor levels with response to chemotherapy for advanced carcinoma of the breast.

Estrogen and progesterone receptor levels were determined simultaneously in tumor samples obtained from 105 patients who subsequently received a trial of hormonal or chemotherapy for metastatic carcinoma of the breast. Twenty-three of 33 estrogen receptor positive patients in contrast with three of 22 estrogen receptor negative patients achieved an objective response to hormonal therapy. More significantly, it was found that 12 of 16 estrogen receptor positive patients compared with only six of 34 estrogen receptor negative patients responded to combination chemotherapy. Simultaneous measurement of progesterone receptor improved the selection of tumors responsive to chemotherapy, as only four of 30 patients who were estrogen receptor negative-progesterone receptor negative achieved a response. Furthermore, the cumulative survival time of 36 months after the first recurrence of carcinoma of the breast was significantly lower in estrogen receptor negative patients receiving chemotherapy. These data indicate that patients with estrogen receptor negative carcinoma of the breast are resistant to standard hormonal and chemotherapeutic measures for metastatic disease and carry a poor prognosis.

Aged↗

RU486: pharmacology and potential use in the treatment of endometriosis and leiomyomata uteri.

More than a decade after the serendipidous discovery of RU486, numerous antiprogestins have been synthesized and studied. Interest in how antiprogestins exert their antagonist effect has led to novel information about the molecular mechanisms of progesterone action. The pivotal role that progesterone plays in reproductive biology has led to research in many areas where a potential role for these compounds may be found in health and disease. RU486 has been shown to relieve pelvic pain associated with endometriosis and to decrease American Fertility Society endometriosis scores. Uterine leiomyomata show a significant reduction in size after administration of RU486 for 3 months. Although much research remains to be carried out, RU486 appears promising as alternative therapies for these diseases.

Endometriosis↗

In vitro transfer rate of 14C from acetate-1-14C into ovarian steroids in the rat ovary during the estrous cycle and effects of LH and FSH.

Fluctuations of ovarian biosynthetic activity and effects of exogenous LH and FSH on it during the estrous cycle were investigated by measuring in vitro transfer rates of 14C from 14C-1-acetate into progesterone (P), 20 alpha-hydroxy-pregn-4-en-3-one (20 alpha-OH-P) and estrogen (estradiol and estrone, E) in the ovarian homogenates from rats autopsied at 2 hour intervals. The transfer rate of 14C from 14C-1-acetate into P was lowest in the afternoon of estrus and increased from the morning of diestrus 1, making its peaks during the afternoon of diestrus 2 and in the midnight of proestrus. The transfer of 14C into 20 alpha-OH-P was high on the days of diestrus 2 and proestrus with its peak in the afternoon of the latter day. The maximum transfer of 14C into E in the afternoon of proestrus and a high rate in the morning of estrus with relatively low one in the midnight were observed. Exogenously injected LH (150 mug) or FSH (150 mug) was either stimulatory or inhiibitory to the transfer rates of 14C from 14C-1-acetate into ovarian steroids. During day time of diestrus 2 and midnight between proestrus and estrus, the transfer of 14C into P and 20 alpha-OH-P increased by LH, and during day time of proestrus and from the afternoon of estrus to the morning of diestrus 1 decreased. The transfer of 14C into E increased by LH from the afternoon of diestrus 2 to the morning of proestrus, and decreased during the afternoon of proestrus and from the afternoon of estrus to the morning of diestrus 2. Administration of FSH was also stimulatory or inhibitory. The 14C transfer into P and 20 alpha-OH-P increased by FSH from the afternoon of estrus to the morning of proestrus, but in the afternoon of proestrus they decreased. Transfer of 14C into E increased by FSH significantly on the days of diestrus 2 and proestrus, and slightly on the day of estrus, while it decreased in the afternoon of diestrus 1.

Acetates↗