Pathology & Oncology Research

, Volume 24, Issue 3, pp 533–540 | Cite as

Estrogen Receptor β as a Prognostic Marker of Tumor Progression in Colorectal Cancer with Familial Adenomatous Polyposis and Sporadic Polyps

  • Paulo Roberto Stevanato FilhoEmail author
  • Samuel Aguiar Júnior
  • Maria Dirlei Begnami
  • Fábio de Oliveira Ferreira
  • Wilson Toshihiko Nakagawa
  • Ranyell Matheus Sobreira Batista Spencer
  • Tiago Santoro Bezerra
  • Philip Edward Boggiss
  • Ademar Lopes
Original Article


The incidence of colorectal cancer (CRC) is lower in women than in men, and sex steroids can be considered contributing factors because oral contraception usage and estrogen replacement therapy are associated with decreased risk. Conversely, colorectal polyp development in familial adenomatous polyposis (FAP) begins during puberty. The objectives were to evaluate the relationship between the expression of these hormone receptors and adenoma-carcinoma progression, CRC stage and overall survival. We studied 120 A.C. Camargo Cancer Center patients diagnosed with either FAP-associated or spontaneous adenomatous polyps or CRC to determine the immunohistochemical expression levels of estrogen receptor (ER)-α, ER-β and the progesterone and androgen receptors (480 analyses). The ER-β expression levels differed between the groups: the group with FAP polyps had lower ER-β expression than that of the sporadic polyp group. With transformation of the sporadic polyps to cancer, there was a considerable decrease in ER-β expression (from 90% with strong expression to 80% with absent or weak expression) (p < 0.001). The ER-β expression was lower in T3/T4 tumors than in T1/T2 tumors (p = 0.015). The 5-year overall survival of CRC patients positively expressing ER-β exceeded that of patients without detectable expression levels (74.8% vs. 44.3%, respectively; p = 0.035). There was no significant expression of the androgen or progesterone receptor or ER-α among the groups. Differences in ER-β expression represent a potential mechanism through which estrogen might alter the susceptibility to colon cancer, thereby confirming the possibility of a protective role of estrogen against colorectal carcinogenesis.


Colorectal cancer Survival Estrogen receptor Familial adenomatous polyposis Hormonal receptors Colorectal carcinogenesis 



We thank Dr. Renata Maymi Takahashi, Bruna Catin and Mariana Petaccia de Macedo, who was also a coworker in this study.

Compliance with Ethical Standards


This study was supported by grants from the State of São Paulo Research Foundation (FAPESP - 1453/10 - The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

Conflict of Interest

The authors declare that there is no conflict of interest.


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Copyright information

© Arányi Lajos Foundation 2017

Authors and Affiliations

  • Paulo Roberto Stevanato Filho
    • 1
    Email author
  • Samuel Aguiar Júnior
    • 1
  • Maria Dirlei Begnami
    • 2
  • Fábio de Oliveira Ferreira
    • 1
  • Wilson Toshihiko Nakagawa
    • 1
  • Ranyell Matheus Sobreira Batista Spencer
    • 1
  • Tiago Santoro Bezerra
    • 1
  • Philip Edward Boggiss
    • 1
  • Ademar Lopes
    • 1
  1. 1.Colorectal Tumor Nucleus of the Pelvic Surgery DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
  2. 2.Department of PathologyA.C. Camargo Cancer CenterSão PauloBrazil

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