title: The Estrogen Pathway: Estrogen Receptor-α, Progesterone Receptor, and Estrogen Receptor-β Expression in Radical Cystectomy Urothelial Cell Carcinoma Specimens.
abstract: OBJECTIVE
  Bladder cancer has the sixth highest incidence in the United States. Treatment of metastatic bladder cancer is difficult, and mortality is certain. There are certain pathways in cancer growth and progression that are important in bladder cancer development. Recently, the estrogen pathway has been found to be a potential target for therapy.
  
  
  METHODS
  We identified 410 patients treated with radical cystectomy for urothelial cell carcinoma between 1990 and 1994. We obtained representative paraffin-embedded tissue blocks for 336 (82.0%) of these cases and evaluated the expression and intensity of estrogen receptor (ER)-α, ER-β, and progesterone receptor by immunohistochemistry.
  
  
  RESULTS
  Among the 12 ER-α-positive cases, median tumor ER-α expression was 10% (range, 10%-50%). In contrast to ER-α, all cases were ER-β-positive. Median tumor ER-β expression was 90% (range, 20%-100%). Nearly all cases had ER-β expression of ≥ 90% (175 [55.9%] with 90% and 103 [32.9%] with 100%). However, the intensity of ER-β staining varied from focal to moderate to marked in 64 (20.5%), 167 (53.4%), and 82 (26.2%) cases, respectively. Progesterone receptor expression was noted to be negative in all cases.
  
  
  CONCLUSIONS
  ER-β is highly expressed in bladder cancer. Prospective validation of these data might further elucidate the utility of ER-β as a marker for prognosis or possible target for therapy.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL. Electronic address: tan.winston@mayo.edu.
authors.forename: Winston
authors.initials: W
authors.lastname: Tan
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN.
authors.forename: Stephen
authors.initials: S
authors.lastname: Boorjian
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL.
authors.forename: Pooja
authors.initials: P
authors.lastname: Advani
authors.affiliation: Division of Biostatistics, Mayo Clinic, Rochester, MN.
authors.forename: Sara
authors.initials: S
authors.lastname: Farmer
authors.affiliation: Division of Biostatistics, Mayo Clinic, Rochester, MN.
authors.forename: Christine
authors.initials: C
authors.lastname: Lohse
authors.affiliation: Division of Laboratory Medicine and Pathology, Department of Anatomic Pathology, Mayo Clinic, Rochester, MN.
authors.forename: John
authors.initials: J
authors.lastname: Cheville
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN.
authors.forename: Eugene
authors.initials: E
authors.lastname: Kwon
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN.
authors.forename: Bradley
authors.initials: B
authors.lastname: Leibovich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D047628:Estrogen Receptor alpha / Q000378:metabolism*; D047629:Estrogen Receptor beta / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011980:Receptors, Progesterone / Q000378:metabolism*; D046888:Tissue Array Analysis / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000378:metabolism / Q000601:surgery*
chemical_list: C506487:ESR1 protein, human; C000600034:ESR2 protein, human; D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011980:Receptors, Progesterone
keywords: Estrogen receptor; Muscle-invasive bladder cancer; Prognosis; Urothelial cell carcinoma