INFLUENCE OF GOSERELIN DEPOT THERAPY ON EPIDERMAL GROWTH-FACTOR RECEPTOR EXPRESSION IN PELVIC ENDOMETRIOSIS

We have studied epidermal growth factor (EGF) receptor expression in e ndometrium and in endometriotic implants, testing a group of 36 women before and after a 4-month gonadotropin-releasing hormone (GnRH) analo g (GnRH-a) goserelin depot treatment. Each woman underwent laparoscopy twice. At the initial laparoscopy, before starting treatment, the dis ease was staged according to the American Fertility Society (AFS) clas sification and biopsies of endometriotic implants were undertaken. The follow-up laparoscopy was performed within 5 weeks of the last GnRH-a administration. Biopsies were taken from areas of previously noted di sease, both visually persistent and visually free of disease. At the t ime of each laparoscopy, photographs of all areas of disease were take n. Specimens of eutopic endometrium were collected from each patient a t the time of laparoscopy by a Novak curette. Endometrial and endometr iotic samples were processed for immunohistochemical detection of EGF receptor, using anti-EGF receptor monoclonal antibody Ab-3. After trea tment, the marked improvement of AFS score was associated with a drama tic reduction of EGF receptor immunostaining, but the exact meaning of this finding is still not completely understood. The dramatic reducti on of EGF receptor expression in eutopic and ectopic endometrium sampl es after treatment is not obviously related to the hypoestrogenism ind uced by the drug. It has been suggested that steroid hormones and EGF play a role in regulation of EGF receptor expression, so that drugs su ch as goserelin depot could act directly at local peripheral level inf luencing the EGF receptor expression via the production of its ligand.