J Breast Cancer.  2012 Mar;15(1):79-86. 10.4048/jbc.2012.15.1.79.

Prognostic Significance of High Expression of ER-beta in Surgically Treated ER-Positive Breast Cancer Following Endocrine Therapy

• Kim TJ
• Lee A
• Choi YJ
• Song BJ
• Yim HW
• Kang CS

• KMID: 2286477
• DOI: http://doi.org/10.4048/jbc.2012.15.1.79

Abstract

PURPOSE
This study evaluated estrogen receptor (ER)-beta mRNA and ER-beta protein expression and its prognostic implications in hormone receptor-positive breast cancer.
METHODS
Paraffin sections from 139 hormone receptor-positive breast cancer cases were prepared. The expression of ER-beta mRNA and protein were analyzed by branched-chain assay and immunohistochemistry (IHC), respectively.
RESULTS
The Allred score of ER-beta IHC was correlated with smaller tumor size (p=0.043), the Allred score of ER-alpha IHC (p<0.001), and the Allred score of progesterone receptor (PR) IHC (p=0.022) but not with the HER2 IHC score. ER-beta mRNA level was correlated with PR mRNA levels (p<0.001) but not with the Allred score of ER-beta IHC, ER-alpha IHC, and PR IHC, nor with the HER2 IHC score and ER-alpha mRNA level. In survival analysis, high expression of ER-beta mRNA was associated with worse disease-free survival along with poor differentiation, lymph node metastasis and absence of PR protein expression in univariate analysis (p=0.040, p=0.002, p=0.018, and p=0.007, respectively) and multivariate analysis (p=0.044, p=0.002, p=0.035, and p=0.007, respectively).
CONCLUSION
High expression of ER-beta mRNA is an independent predictor of disease recurrence in hormone-receptor-positive breast cancer.

Keyword

Breast neoplasms; Estrogen receptor; mRNA; Prognosis; Recurrence

MeSH Terms

Breast
Breast Neoplasms
Disease-Free Survival
Estrogens
Immunohistochemistry
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Paraffin
Prognosis
Receptors, Progesterone
Recurrence
RNA, Messenger
Estrogens
Paraffin
RNA, Messenger
Receptors, Progesterone

Figure

• 

  Figure 1 Estrogen receptor (ER)-beta, ER-alpha, and progesterone receptor (PR) immunohistochemistry (IHC) results in breast carcinomas showed examples of positive nuclear staining of (A) ER-beta (×200), (B) ER-alpha (×200), and (C) PR (×200). HER2 silver in situ hybridization (SISH) results showed (D, E) the examples of HER2 amplification in SISH (D, HER2; E, chromosome 17; HER2/chromosome 17 ratio >2.2) (×400).

• 

  Figure 2 Plot error bar graph (mean, standard deviation, 95% confidence interval), correlation between immunohistochemical staining results of (A) ER-beta versus ER-alpha, (B) ER-beta versus PR, and (C) ER-beta versus HER2. ER=estrogen receptor; PR=progesterone receptor; IHC=immunohistochemistry.

• 

  Figure 3 Plot error bar graph (mean, standard deviation, 95% confidence interval), correlation between (A) ER-beta mRNA level (QuantiGene2.0) versus Allred score of ER-beta immunohistochemistry (IHC), (B) estrogen receptor (ER)-beta mRNA level (QuantiGene 2.0) versus Allred score of ER-alpha IHC, (C) ER-beta mRNA level (QuantiGene2.0) versus Allred score of PR IHC and (D) ER-beta mRNA level (QuantiGene2.0) versus score of HER2 IHC. ER=estrogen receptor; PR=progesterone receptor; IHC=immunohistochemistry.

• 

  Figure 4 Simple scatter plot, correlation between (A) ER-beta mRNA level (QuantiGene2.0) versus ER-alpha mRNA level (QuantiGene2.0) and (B) ER-beta mRNA level (QuantiGene2.0) versus PR mRNA level (QuantiGene2.0). ER=estrogen receptor; PR=progesterone receptor.

• 

  Figure 5 Kaplan-Meier survival curves for disease-free survival stratified by estrogen receptor (ER)-beta mRNA level (low expression [0-2.9] versus high expression [>2.9]).

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