title: Impact of estrogen and progesterone receptor expression on the clinical and molecular features of papillary thyroid cancer.
abstract: BACKGROUND
  Thyroid cancer is highly prevalent in women during the fertile age, which suggests a possible impact of hormonal and reproductive factors.
  
  
  METHODS
  We studied the expression of estrogen receptor α (ERα or ESR1) and progesterone receptor (PR or PGR) in 182 female and male patients with papillary thyroid cancer and correlated it to clinical and molecular features.
  
  
  RESULTS
  ERα and PR expression was found in 66.5 and 75.8% of patients respectively and was significantly correlated with larger tumor size and with a non-incidental diagnosis. Moreover, a trend toward a higher prevalence of local metastases was observed in ER- and PR-expressing tumors, which possibly indicates a more aggressive behavior. Interestingly, the occurrence of the 'receptor conversion' phenomenon, which has already been reported to have a negative prognostic effect in breast cancer, was demonstrated for the first time in thyroid tumors. Indeed, almost all of the ERα-positive primary tumors analyzed had ERα-negative metastatic lymph nodes. At the genetic analyses, BRAF(V600E) mutation was detected in 23.2% of the tumors and had a higher prevalence in larger tumors and in those with a stronger ERα or PR staining.
  
  
  CONCLUSIONS
  The whole of the findings reported in the present study argue for an association between ERα and PR sex hormone receptor expression and a more aggressive presentation. Although no impact on outcome was found, the evaluation of ERα and PR receptor expression could add insights into the biological behavior of tumors and could modify the follow-up, particularly in fertile women affected with persistent disease.
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy guiava@libero.it.
authors: Guia
authors: G
authors: Vannucchi
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Simone
authors: S
authors: De Leo
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Michela
authors: M
authors: Perrino
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Stefania
authors: S
authors: Rossi
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Delfina
authors: D
authors: Tosi
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Valentina
authors: V
authors: Cirello
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Carla
authors: C
authors: Colombo
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Gaetano
authors: G
authors: Bulfamante
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Leonardo
authors: L
authors: Vicentini
authors: Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy Endocrine UnitPadiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122 Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyDivision of PathologySan Paolo Hospital, Milan, ItalyDepartments of Health SciencesPathophysiology and TransplantationUniversity of Milan, Milan, ItalyEndocrine Surgery UnitFondazione IRCCS Ca' Granda, Milan, Italy.
authors: Laura
authors: L
authors: Fugazzola
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D047628:Estrogen Receptor alpha / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000235:genetics / Q000473:pathology; D015995:Prevalence; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult
chemical_list: D047628:Estrogen Receptor alpha; D011980:Receptors, Progesterone; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf