A1 Refereed original research article in a scientific journal
Loss of Estrogen Receptor Beta Expression in Follicular Thyroid Carcinoma Predicts Poor Outcome
Authors: Heikkilä Annukka, Hagström Jaana, Mäenpaa Hanna, Louhimo Johanna, Siironen Päivi, Heiskanen Ilkka, Haglund Caj, Arola Johanna
Publisher: MARY ANN LIEBERT, INC
Publication year: 2013
Journal: Thyroid
Journal name in source: THYROID
Journal acronym: THYROID
Volume: 23
Issue: 4
First page : 456
Last page: 465
Number of pages: 10
ISSN: 1050-7256
eISSN: 1557-9077
DOI: https://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.
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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