title: Steroid hormone receptor expression in ovarian cancer: progesterone receptor B as prognostic marker for patient survival.
abstract: BACKGROUND
  There is partially conflicting evidence on the influence of the steroid hormones estrogen (E) and progesterone (P) on the development of ovarian cancer (OC). The aim of this study was to assess the expression of the receptor isoforms ER-α/-β and PR-A/-B in OC tissue and to analyze its impact on clinical and pathological features and patient outcome.
  
  
  METHODS
  155 OC patients were included who had been diagnosed and treated between 1990 and 2002. Patient characteristics, histology and follow-up data were available. ER-α/-β and PR-A/-B expression were determined by immunohistochemistry.
  
  
  RESULTS
  OC tissue was positive for ER-α/-β in 31.4% and 60.1% and PR-A/-B in 36.2% and 33.8%, respectively. We identified significant differences in ER-β expression related to the histological subtype (p=0.041), stage (p=0.002) and grade (p=0.011) as well as PR-A and tumor stage (p=0.03). Interestingly, median receptor expression for ER-α and PR-A/-B was significantly higher in G1 vs. G2 OC. Kaplan Meier analysis revealed a good prognosis for ER-α positive (p=0.039) and PR-B positive (p<0.001) OC. In contrast, ER-β negative OC had a favorable outcome (p=0.049). Besides tumor grade and stage, Cox-regression analysis showed PR-B to be an independent prognostic marker for patient survival (p=0.009, 95% CI 0.251-0.823, HR 0.455).
  
  
  CONCLUSIONS
  ER-α/-β and PR-A/-B are frequently expressed in OC with a certain variability relating to histological subtype, grade and stage. Univariate analysis indicated a favorable outcome for ER-α positive and PR-B positive OC, while multivariate analysis showed PR-B to be the only independent prognostic marker for patient survival. In conclusion, ER and PR receptors may be useful targets for a more individualized OC therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Grosshadern Campus, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, Munich 81377, Germany. Miriam.Lenhard@med.uni-muenchen.de
authors.forename: Miriam
authors.initials: M
authors.lastname: Lenhard
authors.forename: Lennerová
authors.initials: L
authors.lastname: Tereza
authors.forename: Sabine
authors.initials: S
authors.lastname: Heublein
authors.forename: Nina
authors.initials: N
authors.lastname: Ditsch
authors.forename: Isabelle
authors.initials: I
authors.lastname: Himsl
authors.forename: Doris
authors.initials: D
authors.lastname: Mayr
authors.forename: Klaus
authors.initials: K
authors.lastname: Friese
authors.forename: Udo
authors.initials: U
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047628:Estrogen Receptor alpha / Q000378:metabolism*; D047629:Estrogen Receptor beta / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011980:Receptors, Progesterone / Q000378:metabolism*; D055815:Young Adult
chemical_list: D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011980:Receptors, Progesterone; C101118:progesterone receptor A; C097314:progesterone receptor B