Significance of immunohistochemical expression of estrogen receptors α and β in squamous cell carcinoma of the esophagus

Purpose: Possible significance of sex hormone estrogen as an antitumor therapeutic arm toward esophageal squamous cell carcinoma (ESCC) cells has been suggested. The aim of the current study was to clarify the clinicopathologic significance of an immunohistochemical expression of estrogen receptors alpha and beta (ER alpha and ER beta) in ESCC. Experimental Design: Expression of ERa and ER beta were examined using an immunohistochemical methods in 73 paraffin-embedded sections collected from patients with ESCC who had been subjected to esophageal resection and digestive reconstruction without any preoperative induction therapy. Results: Forty-seven (64.4%) ESCCs had a positive cytoplasmic expression of ER alpha and 21 (28.8%) ESCCs had a positive nuclear expression of ER beta. Univariate analysis showed that both positive ER alpha expression (P = 0.0001) and negative ER beta expression (P = 0.026) were unfavorable prognostic indicators in ESCC. Moreover, multivariate analysis showed that ER alpha-positive/ER beta-negative expression (P = 0.003) and progression of tumor stage (P = 0.014) were found to be independent unfavorable prognostic indicators in ESCCs. Conclusions: Immunohistochemical expression of ER alpha and ER beta were found to be observed in ESCC. Positive expression of ER alpha in addition to negative expression of ER beta proved to be an unfavorable independent prognostic indicator in ESCC.