Role of progesterone in endometrial cancer

Abstract

Progesterone is a key hormone in the endometrium that opposes estrogen-driven growth. Insufficient progesterone will result in unopposed estrogen action that could lead to the development of endometrial hyperplasia and adenocarcinoma. Although these endometrial neoplasias can regress in response to progestin treatment, this does not occur in all instances. To understand this resistance to progesterone and to improve on existing hormonal therapies, it is imperative that the molecular mechanisms of progesterone action through its receptor be deciphered in endometrial cancer. This review highlights what is known thus far regarding the efficacy of progestin therapy in the clinic and the role of progesterone in endometrial cancer cell behavior and gene regulation.

Figure 1

Endometrial tissues were stained with hematoxylin and eosin to distinguish morphology. Depicted are sections of normal, hyperplasia, and endometrial cancer tissues. Notice the change in glandular morphology in hyperplasia and grade 1 endometrial carcinoma.

Figure 2

Schematic illustration of progesterone action on endometrial carcinoma. The complexity of progesterone action can be appreciated because all processes interconnect and influence the tumor response.