title: Expression of estrogen receptor-alpha and -beta and progesterone receptor-A and -B in a large cohort of patients with endometrioid endometrial cancer.
abstract: OBJECTIVE
  The estrogen receptor (ER)-alpha and -beta and progesterone receptor (PR)-A and -B were determined in endometrioid endometrial cancer, and their prognostic values were assessed.
  
  
  METHODS
  Tissue microarrays were constructed from 315 endometrioid endometrial cancer patients. Receptor expression was assessed by immunostaining, and their semi-quantitatively determined expression levels were correlated to classical clinico-histopathological parameters in addition to disease free and disease specific survival.
  
  
  RESULTS
  Patients were classified as FIGO stage I (59.0%), stage II (17.1%), stage III (19.4%) and stage IV (4.1%). Sixty-five patients (20.6%) developed recurrent disease and 38 (12.1%) died due to endometrial cancer. In univariate analysis, expression of ER-alpha was related to early stage endometrial cancer (p=0.020), while expression of ER-alpha, PR-A and PR-B was associated with lower grade tumours (p<0.0001, p<0.001 and p=0.001 respectively). A ratio of ER-alpha/ER-beta <1 was related to a shorter disease free survival (p=0.027), while the ratio of PR-A/PR-B <1 both was associated with a shorter disease free survival as well as a shorter overall survival (p=0.044 and p=0.005, respectively). In early stage disease, using multivariate analysis, absence of ER-alpha was independently related to death of disease (p=0.017, OR 7.28, 95% CI 1.42-37.25), while absence of PR-A (p=0.015, OR 4.2, 95% CI 1.32-13.33) appeared to be an independent prognostic factor for relapse of disease.
  
  
  CONCLUSIONS
  We conclude that in early stage endometrioid endometrial cancer absence of PR-A is an independent prognostic factor for disease-free survival, while patients with ER-alpha positive tumours have a better overall survival.
authors.affiliation: Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jongen
authors.forename: Justine
authors.initials: J
authors.lastname: Briët
authors.forename: Renske
authors.initials: R
authors.lastname: de Jong
authors.forename: Klaske
authors.initials: K
authors.lastname: ten Hoor
authors.forename: Marike
authors.initials: M
authors.lastname: Boezen
authors.forename: Ate
authors.initials: A
authors.lastname: van der Zee
authors.forename: Hans
authors.initials: H
authors.lastname: Nijman
authors.forename: Harry
authors.initials: H
authors.lastname: Hollema
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D018269:Carcinoma, Endometrioid / Q000378:metabolism* / Q000473:pathology; D015331:Cohort Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000473:pathology; D047628:Estrogen Receptor alpha / Q000096:biosynthesis*; D047629:Estrogen Receptor beta / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011980:Receptors, Progesterone; C101118:progesterone receptor A; C097314:progesterone receptor B