title: Expression of estrogen and androgen receptors in differentiated thyroid cancer: an additional criterion to assess the patient's risk.
abstract: Estrogen receptor (ER) and androgen receptor (AR) may be expressed in thyroid tumors, but their prognostic role is controversial. We investigated whether ER and AR expressions could confer a more aggressive phenotype to thyroid tumors. We enrolled 91 patients (13 males and 78 females, mean age 49.3±14.8 years) bearing small (T1 in the 2006 TNM system) differentiated thyroid cancers (DTC). Thirty-eight tumors were incidental histological findings. Using immunohistochemistry, we evaluated ERα, ERβ, and AR expressions in tumors and in its correspondent extra-tumor parenchyma. In tumors, 13 (16.7%) women and one (7.7%) man expressed ERα; 42 (53.8%) women and six (46%) men expressed ERβ; and 16 (20.5%) women and three (23.1%) men expressed AR. In normal thyroid parenchymas, ERβ was expressed in 52 (66.7%) women and nine (69.2%) men, ERα in three (3.8%) women, and AR in 13 (16.7%) women. Compared with normal thyroid parenchyma, tumors gained ERα and lost ERβ expressions. Incidental cancers were more commonly ERα(-) than ERα(+) (47.7 vs 14.3%, P=0.037). Postsurgical serum thyroglobulin was higher in ERα(+) tumors than in the ERα(-) tumors (P=0.04). ERβ(-) tumors showed vascular invasion more frequently than the ERβ(+) tumors (26.2 vs 4.1%, P=0.005). AR(+) tumors showed capsular invasion more frequently than the AR(-) tumors (77.8 vs 46.6%, P=0.014). In conclusion, ERα positivity, ERβ negativity, and AR expressions are associated with a more aggressive phenotype of small T1-DTC. ER and AR expressions may represent an additional criterion in deciding whether to perform radioiodine ablation in these tumors.
authors.affiliation: Units of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri IRCCS, University of Pavia, 27100 Pavia, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Magri
authors.forename: Valentina
authors.initials: V
authors.lastname: Capelli
authors.forename: Mario
authors.initials: M
authors.lastname: Rotondi
authors.forename: Paola
authors.initials: P
authors.lastname: Leporati
authors.forename: Luigi
authors.initials: L
authors.lastname: La Manna
authors.forename: Rubina
authors.initials: R
authors.lastname: Ruggiero
authors.forename: Alberto
authors.initials: A
authors.lastname: Malovini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bellazzi
authors.forename: Laura
authors.initials: L
authors.lastname: Villani
authors.forename: Luca
authors.initials: L
authors.lastname: Chiovato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D002454:Cell Differentiation / Q000235:genetics; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D011944:Receptors, Androgen / Q000235:genetics*; D011960:Receptors, Estrogen / Q000235:genetics*; D012307:Risk Factors; D013954:Thyroglobulin / Q000032:analysis / Q000097:blood; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D055815:Young Adult
chemical_list: D011944:Receptors, Androgen; D011960:Receptors, Estrogen; D013954:Thyroglobulin