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Obstetrics & Gynecology 2008;111:144-151
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Estrogen Receptor Subtypes in Ovarian Cancer

A Clinical Correlation

Karen K. L. Chan, MD1, Na Wei, BSc1, Stephanie S. Liu, PhD1, Liao Xiao-Yun, MPhil2, Annie N. Cheung, MD2 and Hextan Y. S. Ngan, MD1

From the Departments of 1Obstetrics and Gynecology and 2Pathology, University of Hong Kong, Hong Kong.

OBJECTIVE: To study the distribution of estrogen receptor (ER) subtypes in ovarian tumors and to correlate the levels of expression with clinical factors.

METHODS: Estrogen receptor-{alpha} (ER{alpha}) and β-mRNA expressions in 58 normal, 25 borderline, and 161 malignant ovarian tissue samples were determined by quantitative real-time polymerase chain reaction. The expression levels were correlated with clinical data, including the histologic subtypes, the stage of the disease, and the disease-free and overall survival, with a median follow-up of 80 months.

RESULTS: Estrogen receptor-β (ERβ) expression, but not ER{alpha}, was significantly higher in normal tissues compared with malignant tissues (P<.001). Estrogen receptor-β expression was also significantly higher in stage I disease compared with stage II-IV disease (P<.001). A higher ERβ expression was found to be significantly associated with a longer disease-free survival (P=.007) as well as overall survival (P=.011). Estrogen receptor-β expression remained a significant predictor for disease-free survival and overall survival in multivariable analysis that took into account other factors that were shown to be associated with survival in univariate analyses, including stage of disease, type of tumor (borderline or malignant), and optimal debulking.

CONCLUSION: Loss of ERβ expression in ovarian tumors may be a feature of malignant transformation. Determining ER subtypes expression may improve response to hormonal therapy by tailoring the use of selective estrogen receptor modulators with different ER affinity in selected women. As a prognostic indicator, ERβ levels may be useful in deciding the need for and choice of adjuvant treatment in women with early ovarian cancers.

LEVEL OF EVIDENCE: II






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