TY - JOUR
T1 - The Estrogen Pathway
T2 - Estrogen Receptor-α, Progesterone Receptor, and Estrogen Receptor-β Expression in Radical Cystectomy Urothelial Cell Carcinoma Specimens
AU - Tan, Winston
AU - Boorjian, Stephen
AU - Advani, Pooja
AU - Farmer, Sara
AU - Lohse, Christine
AU - Cheville, John
AU - Kwon, Eugene
AU - Leibovich, Bradley
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - The estrogen pathway has been implicated in bladder cancer growth and progression. We evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor in patients with urothelial cell carcinoma who were treated with cystectomy. Progesterone receptor expression was negative in all cases. ER-α expression was noted in 12 of 318 patients, and ER-β expression was noted in all patients. Marked ER-β intensity was associated with decreased lymph node metastasis, smaller tumor size, preoperative Bacillus Calmettee - Guérin, and less nonorgan-confined disease, suggesting a potential prognostic role of ER-β in urothelial cell carcinoma. Objective: Bladder cancer has the sixth highest incidence in the United States. Treatment of metastatic bladder cancer is difficult, and mortality is certain. There are certain pathways in cancer growth and progression that are important in bladder cancer development. Recently, the estrogen pathway has been found to be a potential target for therapy. Methods: We identified 410 patients treated with radical cystectomy for urothelial cell carcinoma between 1990 and 1994. We obtained representative paraffin-embedded tissue blocks for 336 (82.0%) of these cases and evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor by immunohistochemistry. Results: Among the 12 ER-α-positive cases, median tumor ER-α expression was 10% (range, 10%-50%). In contrast to ER-α, all cases were ER-β-positive. Median tumor ER-β expression was 90% (range, 20%-100%). Nearly all cases had ER-β expression of ≥ 90% (175 [55.9%] with 90% and 103 [32.9%] with 100%). However, the intensity of ER-β staining varied from focal to moderate to marked in 64 (20.5%), 167 (53.4%), and 82 (26.2%) cases, respectively. Progesterone receptor expression was noted to be negative in all cases. Conclusions: ER-β is highly expressed in bladder cancer. Prospective validation of these data might further elucidate the utility of ER-β as a marker for prognosis or possible target for therapy.
AB - The estrogen pathway has been implicated in bladder cancer growth and progression. We evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor in patients with urothelial cell carcinoma who were treated with cystectomy. Progesterone receptor expression was negative in all cases. ER-α expression was noted in 12 of 318 patients, and ER-β expression was noted in all patients. Marked ER-β intensity was associated with decreased lymph node metastasis, smaller tumor size, preoperative Bacillus Calmettee - Guérin, and less nonorgan-confined disease, suggesting a potential prognostic role of ER-β in urothelial cell carcinoma. Objective: Bladder cancer has the sixth highest incidence in the United States. Treatment of metastatic bladder cancer is difficult, and mortality is certain. There are certain pathways in cancer growth and progression that are important in bladder cancer development. Recently, the estrogen pathway has been found to be a potential target for therapy. Methods: We identified 410 patients treated with radical cystectomy for urothelial cell carcinoma between 1990 and 1994. We obtained representative paraffin-embedded tissue blocks for 336 (82.0%) of these cases and evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor by immunohistochemistry. Results: Among the 12 ER-α-positive cases, median tumor ER-α expression was 10% (range, 10%-50%). In contrast to ER-α, all cases were ER-β-positive. Median tumor ER-β expression was 90% (range, 20%-100%). Nearly all cases had ER-β expression of ≥ 90% (175 [55.9%] with 90% and 103 [32.9%] with 100%). However, the intensity of ER-β staining varied from focal to moderate to marked in 64 (20.5%), 167 (53.4%), and 82 (26.2%) cases, respectively. Progesterone receptor expression was noted to be negative in all cases. Conclusions: ER-β is highly expressed in bladder cancer. Prospective validation of these data might further elucidate the utility of ER-β as a marker for prognosis or possible target for therapy.
KW - Estrogen receptor
KW - Muscle-invasive bladder cancer
KW - Prognosis
KW - Urothelial cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84941599386&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84941599386&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2015.04.001
DO - 10.1016/j.clgc.2015.04.001
M3 - Article
C2 - 25981333
AN - SCOPUS:84941599386
SN - 1558-7673
VL - 13
SP - 476
EP - 484
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 5
ER -