Prognostic significance and clinical importance of estrogen receptor α and β in human endometrioid adenocarcinomas

Abstract

Abstract. Human endometrial cancer expresses both the known estrogen receptors (ER-· and ER-ß). The significance of the relative expression of both ER subtypes in endometrial adenocarcinomas remains to be clarified and the usefulness of the determination of the receptor status in endometrial cancer patients is still controversially discussed. Therefore, the aims of this study were the evaluation of the expression patterns of ER-· and ER-ß with the characterization of the prognostic significance in uterine endometrioid adenocarcinomas. Pathological and surgical records of 214 patients who were diagnosed with an endometrioid adenocarcinoma without other histological types (including mucinous, mixed, squamous or villoglandular differentiation) were reviewed for both estrogen receptors. The expression of both estrogen receptors was demonstrated in malignant endometrioid adenocarcinomas. ER-· was associated with histological differentiation, while ER-ß demonstrated an association with ovarial invasion. The loss of receptor positivity for ER-· resulted in a poorer causespecific survival in endometrial cancer patients, while ER-ß did not affect survival. Interestingly, metastatic patients who expressed ER-· or ER-ß had a better survival outcome than estrogen receptor negative patients. Moreover, when tumor samples of affected patients expressed ER-·, they had a better cause-specific survival compared to negative findings regarding both estrogen receptors. However, ER-· and ER-ß were not independent factors with survival in endometrial adenocarcinoma patients. Therefore, the analysis of both estrogen receptors might be used as a marker to identify highrisk patients only in a subset of patients with endometrioid adenocarcinoma.

Comparative Cistromics Reveals Genomic Cross-talk between FOXA1 and ERα in Tamoxifen-Associated Endometrial Carcinomas

“…FOXA1 þ /ERa À tumors were enriched among tamoxifen-treated patients at the expense of the tumors that are positive for both ERa and FOXA1 (Fisher exact test: P ¼ 0.018). ERa expression strongly associated with endometrial cancer patient survival, in agreement with previous immunohistochemical reports (39,40). In contrast to previous reports (33,34), FOXA1 expression did not associate with survival of endometrial cancer patients, irrespective whether they did (Fig.…”

Role of estrogen receptor β in gynecological cancer

“…Another study of 315 endometrial adenocarcinoma patients showed a decreased ERα/ERβ ratio to be associated with shorter DFS and OS [63]. In contrast, expression of ERβ alone did not show any correlation with clinicopathological features [65,67]. Thus, prognostic information may only be achieved when ERα and ERβ are analyzed together.…”

“…This finding, however, could not be confirmed yet [62]. A decreased ERα/ERβ ratio has been found to be associated with ovarian invasion in a large study comprising 214 endometrial carcinoma samples [65]. Low ERα/ERβ ratios have also been suggested to lead to progression of myometrial invasion [57,64,66].…”

Tumor progression, metastasis, and modulators of epithelial–mesenchymal transition in endometrioid endometrial carcinoma: an update

“…ER-B is highly expressed in EC with severe myometrial invasion and an important role of this receptor isoform in the progression of myometrial invasion has been suggested (Mylonas 2010). Pertinently an extensive myometrial invasion may be a progeny of EMT which has been implicated in invasive characteristics of endometrial tumors (Montserrat et al 2011).…”