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Immunohistological localization of pregnancyassociated endometrial α2‐globulin (α2‐PEG) in endometrial adenocarcinoma and effect of medroxyprogesterone acetate

Summary. Endometrium from postmenopausal women with endometrial adenocarcinoma was examined immunohistochemically using a monoclonal antibody to pregnancy‐associated endometrial α2‐globulin (α2‐PEG), the major secretory protein of the glandular epithelium during the late luteal phase of the menstrual cycle and early pregnancy. Specimens were obtained at initial diagnostic curettage and at hysterectomy after medroxyprogesterone acetate (MPA) therapy. α2‐PEG was not detected in any malignant tissue irrespective of histological differentiation. Non‐malignant endometrium obtained in association with malignant tissue was negative for α2‐PEG before treatment although after MPA therapy all specimens obtained exhibited marked α2‐PEG localization in glands. In four specimens endogenous alkaline phosphatase was observed consistently only in the malignant endometrium. Malignant endometrium does not appear to synthesize α2‐PEG nor is its synthesis induced by an oral progestogen, so that it does not represent a useful marker for endometrial carcinoma. Non‐malignant endometrium in postmenopausal women appears to be fully capable of α2‐PEG production after stimulation with an oral progestogen.