Background: Response to hormonal therapy in advanced and recurrent endometrial cancer (EC) can be predicted by oestrogen and progesterone receptor immunohistochemical (ER/PR-IHC) expression, with response rates of 60% in PR-IHC > 50% cases. ER/PR-IHC can vary by tumour location and is frequently lost with tumour progression. Therefore, we explored the relationship between ER/PR-IHC expression and tumour location in EC. Methods: Pre-treatment tumour biopsies from 6 different sites of 80 cases treated with hormonal therapy were analysed for ER/PR-IHC expression and classified into categories 0–10%, 10–50%, and >50%. The ER pathway activity score (ERPAS) was determined based on mRNA levels of ER-related target genes, reflecting the actual activity of the ER receptor. Results: There was a trend towards lower PR-IHC (33% had PR > 50%) and ERPAS (27% had ERPAS > 15) in lymphogenic metastases compared to other locations (p= 0.074). Hematogenous and intra-abdominal metastases appeared to have high ER/PR-IHC and ERPAS (85% and 89% ER-IHC > 50%; 64% and 78% PR-IHC > 50%; 60% and 71% ERPAS > 15, not significant). Tumour grade and previous radiotherapy did not affect ER/PR-IHC or ERPAS. Conclusions: A trend towards lower PR-IHC and ERPAS was observed in lymphogenic sites. Verification in larger cohorts is needed to confirm these findings, which may have implications for the use of hormonal therapy in the future.
背景：晚期及复发性子宫内膜癌（EC）对激素治疗的反应可通过雌激素和孕激素受体免疫组化（ER/PR-IHC）表达进行预测，其中PR-IHC>50%的病例缓解率达60%。ER/PR-IHC表达可能因肿瘤部位而异，并常随肿瘤进展而丢失。因此，本研究探讨了EC中ER/PR-IHC表达与肿瘤部位的关系。方法：对80例接受激素治疗患者6个不同部位的预处理肿瘤活检样本进行ER/PR-IHC检测，按表达水平分为0-10%、10-50%及>50%三组。基于ER相关靶基因mRNA水平计算ER通路活性评分（ERPAS），以反映ER受体的实际活性。结果：与其他部位相比，淋巴转移灶呈现PR-IHC（33%病例PR>50%）与ERPAS（27%病例ERPAS>15）降低趋势（p=0.074）。血行转移与腹腔内转移灶则表现出较高的ER/PR-IHC及ERPAS（ER-IHC>50%者分别占85%和89%；PR-IHC>50%者分别占64%和78%；ERPAS>15者分别占60%和71%，差异无统计学意义）。肿瘤分级与既往放疗史未对ER/PR-IHC或ERPAS产生影响。结论：淋巴转移部位存在PR-IHC与ERPAS降低趋势，需通过更大规模队列验证该发现，这可能对未来激素治疗的临床应用具有指导意义。
肿瘤(癌症)患者之家