Sex hormone receptor expression and survival in esophageal adenocarcinoma: a prospective cohort study
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Úna C. McMenamin1, James Trainor2, Helen G. Coleman5, Damian T. McManus2, Stephen McQuaid3, Victoria Bingham3, Jacqueline James3, Manuel Salto-Tellez3, Brian T. Johnston4 and Richard C. Turkington5
1Cancer Epidemiology Research Group, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, UK
2Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
3Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland, UK
4Department of Gastroenterology, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
5Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland, UK
Úna C. McMenamin, email: firstname.lastname@example.org
Keywords: estrogen receptor; androgen receptor; esophageal adenocarcinoma; survival; recurrence
Received: June 18, 2018 Accepted: October 06, 2018 Published: October 19, 2018
Introduction: A striking epidemiological feature of esophageal adenocarcinoma (EAC) is its strong, unexplained male predominance but few studies have evaluated the prevalence of sex hormone receptor expression in EAC.
Results: A low proportion of EAC tumors stained positive for ERα (4%) and AR (3%) while approximately one third stained positive for ERβ (31%). After a mean follow-up of 3 years (max 9 years), no significant associations were seen for ERα, ERβ or AR expression and EAC recurrence or survival. A non-significant reduction in mortality was observed for positive ERβ tumor expression, when restricting to patients with gastro-esophageal junctional (GEJ) cancer (HR 0.58, 95% CI 0.33, 1.03, p = 0.06).
Materials and Methods: We identified all EAC patients who underwent neo-adjuvant chemotherapy prior to surgical resection between 2004–2012 in the Northern Ireland Cancer Centre. Immunohistochemical expression of ERα, ERβ and AR was scored on triplicate cores to generate H-scores. Cox proportional hazards regression was used to evaluate the association between sex hormone receptor expression and overall, cancer-specific and recurrence-free survival.
Conclusion: We found little evidence of ERα or AR expression in EAC. A moderate proportion expressed ERβ and there was suggestive evidence that its expression was associated with improved survival in GEJ cancer patients.
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