title: Estrogen receptor subtypes in ovarian cancer: a clinical correlation.
abstract: OBJECTIVE
  To study the distribution of estrogen receptor (ER) subtypes in ovarian tumors and to correlate the levels of expression with clinical factors.
  
  
  METHODS
  Estrogen receptor-alpha (ERalpha) and beta-mRNA expressions in 58 normal, 25 borderline, and 161 malignant ovarian tissue samples were determined by quantitative real-time polymerase chain reaction. The expression levels were correlated with clinical data, including the histologic subtypes, the stage of the disease, and the disease-free and overall survival, with a median follow-up of 80 months.
  
  
  RESULTS
  Estrogen receptor-beta (ERbeta) expression, but not ERalpha, was significantly higher in normal tissues compared with malignant tissues (P<.001). Estrogen receptor-beta expression was also significantly higher in stage I disease compared with stage II-IV disease (P<.001). A higher ERbeta expression was found to be significantly associated with a longer disease-free survival (P=.007) as well as overall survival (P=.011). Estrogen receptor-beta expression remained a significant predictor for disease-free survival and overall survival in multivariable analysis that took into account other factors that were shown to be associated with survival in univariate analyses, including stage of disease, type of tumor (borderline or malignant), and optimal debulking.
  
  
  CONCLUSIONS
  Loss of ERbeta expression in ovarian tumors may be a feature of malignant transformation. Determining ER subtypes expression may improve response to hormonal therapy by tailoring the use of selective estrogen receptor modulators with different ER affinity in selected women. As a prognostic indicator, ERbeta levels may be useful in deciding the need for and choice of adjuvant treatment in women with early ovarian cancers.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong. kklchan@hkucc.hku.hk
authors.forename: Karen K L
authors.initials: KK
authors.lastname: Chan
authors.forename: Na
authors.initials: N
authors.lastname: Wei
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Liu
authors.forename: Liao
authors.initials: L
authors.lastname: Xiao-Yun
authors.forename: Annie N
authors.initials: AN
authors.lastname: Cheung
authors.forename: Hextan Y S
authors.initials: HY
authors.lastname: Ngan
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D047628:Estrogen Receptor alpha / Q000235:genetics / Q000378:metabolism*; D047629:Estrogen Receptor beta / Q000235:genetics / Q000378:metabolism*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology; D010053:Ovary / Q000473:pathology; D010865:Pilot Projects; D012333:RNA, Messenger / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D012333:RNA, Messenger