Immunohistochemical expression of ERα, ERβ, and TFF1 in type I and II ovarian tumors

A systematic review and meta-analysis of hormone receptor expression in low-grade serous ovarian carcinoma

OBJECTIVE

Serous ovarian carcinoma is the most common histological type of ovarian cancer, with high-grade serous ovarian carcinoma (HGSOC) being more common than low-grade serous ovarian carcinoma (LGSOC). Despite pathogenic and clinical differences, both grades of serous ovarian carcinoma share the propensity to express receptors for the female hormones - oestrogen (ERs) and progesterone receptors (PRs) - albeit in differing frequencies.

STUDY DESIGN

Systematic review and meta-analysis of studies reporting the expression of hormone receptors in LGSOC, and comparison with expression in HGSOC.

RESULTS

Expression of ERs is observed in 80.7 % of patients with LGSOC [95 % confidence interval (CI) 72.2-89.1 %] and 61.5 % of patients with HGSOC (95 % CI 38.8-84.1 %). Expression of PRs is observed in 54.4 % of patients with LGSOC (95 % CI 44.3-64.4 %) and 30.7 % of patients with HGSOC (95 % CI 15.7-45.7 %).

CONCLUSION

A higher percentage of LGSOCs are positive for ER expression compared with HGSOCs. Similarly, a higher percentage of LGSOCs are positive for PR expression, although PR expression is lower than ER expression. Expression of hormone receptors may represent a therapeutic opportunity for treatment with agents that block their activity, especially in LGSOC which is less responsive to chemotherapy and therapeutic options are limited.

Risk of endometrial cancer among women with benign ovarian tumors - A Danish nationwide cohort study

OBJECTIVE

The few studies on the association between benign ovarian tumors and endometrial cancer have been inconclusive. Using data from a large Danish register-based cohort study, we assessed the overall and type-specific risk of endometrial cancer among women with a benign ovarian tumor.

METHODS

We identified all Danish women diagnosed with a benign ovarian tumor during 1978-2016 in the Danish National Patient Register (n = 149,807). The study population was followed for subsequent development of endometrial cancer by linkage to the Danish Cancer Register and standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (CIs) were calculated after correction for hysterectomy.

RESULTS

After a one-year delayed study entry, women with benign ovarian tumors had a decreased incidence of endometrial cancer (SIR = 0.74, 95% CI: 0.68-0.81) compared with women in the general Danish population. Both solid benign ovarian tumors (SIR = 0.79, 95% CI 0.70-0.88) and cystic benign ovarian tumors (SIR = 0.68, 95% CI 0.58-0.78) were associated with decreased incidences of endometrial cancer. Likewise, women with benign ovarian tumors had decreased incidences of both type I and type II endometrial cancer. The incidence of endometrial cancer was decreased to virtually the same magnitude irrespective of the age at diagnosis of a benign ovarian tumor and the reduction persisted throughout the follow-up period.

CONCLUSIONS

The risk of endometrial cancer was decreased beyond the first year after a benign ovarian tumor and the decrease persisted for 20 or more years. The possible underlying mechanisms are not known and should be investigated further.

Immunohistochemical expression of ER-α and PR in papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most common thyroid cancer with multiple risk factors including exposure to ionising radiation. Oestrogens contribute to papillary carcinoma development by promoting cell proliferation and invasion of mutated epithelial follicular cells. The present study aimed to assess ER-α and PR expression in PTC and to correlate their expression with the clinicopathological parameters in this cancer. This study included 62 primary and six metastatic papillary thyroid carcinoma cases. Nineteen and 38.7% of primary PTC cases showed positive nuclear expression for ER and PR, respectively. Metastatic cases showed 66.7% positive ER expression and all were negative for PR. Oestrogen receptor expression showed significant higher positivity in metastatic compared to primary PTC (p = 0.02) and it was significantly associated with primary PTC associated with thyroiditis (p = .002). Progesterone receptor expression was significantly associated with old age in primary PTC (p = .003) and it showed significant coparallel expression with ER (p = .000). Oestrogen and progesterone receptors expressed in papillary thyroid carcinoma opening the door for further studies to verify if those patients could benefit from hormonal therapy. Oestrogen receptor seems to have a role in metastatic process of PTC as malignant cells express it in metastatic more than primary site. The presence of lymphocytes in the stroma may promote ER expression in adjacent PTC, necessitating further studies on PTC cases associated with Hashimoto thyroiditis to verify this assumed relationship.