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Pathol Oncol Res. 2018 Jul;24(3):533-540. doi: 10.1007/s12253-017-0268-5. Epub 2017 Jul 5.

Estrogen Receptor β as a Prognostic Marker of Tumor Progression in Colorectal Cancer with Familial Adenomatous Polyposis and Sporadic Polyps.

Author information

1
Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil. paulo.stevanato@accamargo.org.br.
2
Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil.
3
Department of Pathology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.

Abstract

The incidence of colorectal cancer (CRC) is lower in women than in men, and sex steroids can be considered contributing factors because oral contraception usage and estrogen replacement therapy are associated with decreased risk. Conversely, colorectal polyp development in familial adenomatous polyposis (FAP) begins during puberty. The objectives were to evaluate the relationship between the expression of these hormone receptors and adenoma-carcinoma progression, CRC stage and overall survival. We studied 120 A.C. Camargo Cancer Center patients diagnosed with either FAP-associated or spontaneous adenomatous polyps or CRC to determine the immunohistochemical expression levels of estrogen receptor (ER)-α, ER-β and the progesterone and androgen receptors (480 analyses). The ER-β expression levels differed between the groups: the group with FAP polyps had lower ER-β expression than that of the sporadic polyp group. With transformation of the sporadic polyps to cancer, there was a considerable decrease in ER-β expression (from 90% with strong expression to 80% with absent or weak expression) (p < 0.001). The ER-β expression was lower in T3/T4 tumors than in T1/T2 tumors (p = 0.015). The 5-year overall survival of CRC patients positively expressing ER-β exceeded that of patients without detectable expression levels (74.8% vs. 44.3%, respectively; p = 0.035). There was no significant expression of the androgen or progesterone receptor or ER-α among the groups. Differences in ER-β expression represent a potential mechanism through which estrogen might alter the susceptibility to colon cancer, thereby confirming the possibility of a protective role of estrogen against colorectal carcinogenesis.

KEYWORDS:

Colorectal cancer; Colorectal carcinogenesis; Estrogen receptor; Familial adenomatous polyposis; Hormonal receptors; Survival

PMID:
28681123
DOI:
10.1007/s12253-017-0268-5
[Indexed for MEDLINE]

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