A1 Refereed original research article in a scientific journal

Loss of Estrogen Receptor Beta Expression in Follicular Thyroid Carcinoma Predicts Poor Outcome




AuthorsHeikkilä Annukka, Hagström Jaana, Mäenpaa Hanna, Louhimo Johanna, Siironen Päivi, Heiskanen Ilkka, Haglund Caj, Arola Johanna

PublisherMARY ANN LIEBERT, INC

Publication year2013

JournalThyroid

Journal name in sourceTHYROID

Journal acronymTHYROID

Volume23

Issue4

First page 456

Last page465

Number of pages10

ISSN1050-7256

eISSN1557-9077

DOIhttps://doi.org/10.1089/thy.2012.0363


Abstract
Background: Well-differentiated follicular thyroid carcinomas (FTCs) usually act indolently, while aggressively acting tumors are difficult to detect early enough. Estrogen receptors (ERs) have prognostic significance in many cancers. Thyroid diseases, including neoplasms, are associated with the female sex. The prognostic significance of ERs in FTCs has not been reported previously.
Methods: We studied the role of ERα and ERβ in 83 cases of follicular thyroid adenomas (FTA) and 43 FTC cases, including seven cases of poorly differentiated FTC, obtained from the Department of Surgery, Helsinki University Central Hospital between 1990 and 2009. Patient follow-up was conducted until March 2011. Expression of ERα, ERβ, and MIB-1/Ki-67 was investigated by immunohistochemistry and correlated with clinicopathological characteristics, including survival.
Results: Two major observations were apparent. First, ERβ expression was significantly higher in FTA than in FTC, and it was a stronger differential diagnostic marker than MIB-1/Ki-67. Second, low ERβ expression correlated with poor survival in FTC. All cancer-specific deaths due to FTC were among low ERβ-score patients.
Conclusion: ERβ is a differential marker for malignancy and could thus be used as a preoperative tool. FTC patients with a low ERβ score need more thorough follow-up and may benefit from more aggressive treatment.



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