Expression of estrogen receptor alpha is associated with prolactin pituitary tumor prognosis and supports the sex-related difference in tumor growth.

Abstract

CONTEXT:

A sex difference in the progression of prolactin (PRL) tumors has been disputed for years.

OBJECTIVE:

To compare tumor characteristics and postoperative clinical course between men and women, and correlate data with estrogen receptor alpha (ERα (ESR1)) expression status.

DESIGN, PATIENTS, AND METHODS:

Eighty-nine patients (59 women and 30 men) operated on for a prolactinoma and followed for at least 5 years were selected. Tumors were classified into five grades according to their size, invasion, and proliferation characteristics. The ERα expression was detected by immunohistochemistry and a score (0-12) calculated as the product of the percentage of positive nuclei and the staining intensity.

RESULTS:

We found a significant preponderance of high-grade tumors among men and a lower surgical cure rate in men (23%) than in women (71%). Patients resistant to medical treatment were mainly men (7/8), six of whom showed tumor progression despite postoperative medical treatment, which led to multiple therapies and eventually death in three. The median score for ERα expression was 1 in men (range, 0-8) and 8 in women (range, 0-12) (P<0.0001). The expression of ERα was inversely correlated with tumor size (r=-0.59; P<0.0001) and proliferative activity. All dopamine agonist-resistant tumors and all grade 2b (invasive and proliferative) tumors (from ten men and four women) were characterized by low ERα expression.

CONCLUSIONS:

PRL tumors in men are characterized by lower ERα expression, which is related to higher tumor grades, resistance to treatment, and an overall worse prognosis.

• Authors: Etienne Delgrange, Alexandre Vasiljevic, Anne Wierinckx, Patrick François, Emmanuel Jouanneau, Gérald Raverot, Jacqueline Trouillas
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 172 Issue 6 Pg. 791-801 (Jun 2015) ISSN: 1479-683X [Electronic] England
• PMID: 25792376 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2015 European Society of Endocrinology.

Chemical References

• ESR1 protein, human
• Estrogen Receptor alpha

Topics

• Adult
• Estrogen Receptor alpha (metabolism)
• Female
• Humans
• Male
• Middle Aged
• Pituitary Neoplasms (pathology, surgery)
• Prognosis
• Prolactinoma (pathology, surgery)
• Registries
• Sex Factors
• Treatment Outcome