Abstract
Purpose
The role of estrogen receptor beta (ER-β) expression in pancreatic ductal adenocarcinoma (PDAC) is largely unknown. Ligand-independent phosphorylation and activation of ER-β may play a relevant role in the IL-6/STAT3 signaling pathway and, as a result, in tumor progression. Here, we examined the effect of ER-β, phosphorylated ER-β (pER-β), STAT3, phosphorylated STAT3 (pSTAT3) and IL-6 expression on the overall and recurrence-free survival in a cohort of patients with resected PDAC.
Methods
We identified 175 patients who underwent pancreatic resection for PDAC. Tissue microarrays were constructed from the archival tumor specimens. These were stained with specific antibodies for the above molecules. The expression of the markers was then correlated with clinicopathological parameters and survival analysis was performed.
Results
High nuclear expression of ER-β was found in 61.7% and pER-β in 80.6% of the tumors. STAT3 was expressed in 54.3% of the tumor samples, pSTAT3 in 68% and IL-6 in 76.6%. The median overall survival for patients with low pER-β expression was 29 months, whereas for patients with high pER-β expression was 15.1 months (p = 0.016). Multivariate analysis revealed that pER-β expression was an independent factor correlating with shorter overall survival (hazard ratio 1.9; p = 0.013) and disease-free survival (hazard ratio 1.9; p = 0.029).
Conclusions
Expression of pER-β constitutes an independent prognostic marker for PDAC and is correlated with poor prognosis. These data may help in identifying novel drug targets in PDAC and patients who could benefit from additional therapeutic regimens, including selective estrogen receptor modulators.
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Acknowledgements
We thank Mrs. Andrea Sendelhofert (Institute of Pathology, Ludwig-Maximilians-University, Munich) for her expertise and technical assistance in tissue microarray immunohistochemistry staining and Dipl.-Math. Andrea Stroux (Institute of Biometry und Clinical Epidemiology, Charité—Universitätsmedizin Berlin) for her valuable advice on statistical analysis. This work was conducted in the framework of a PhD programme at Charité Universitätsmedizin Berlin and has been published as a part of a full thesis in the library of the Freie Universität Berlin.
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The study was approved by the Ethics Committee of the Hospital of the University of Munich.
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This work was conducted in the framework of a PhD programme at Charité Universitätsmedizin Berlin, Berlin, Germany and has been published as a part of a full thesis in the library of the Freie Universität Berlin (http://www.diss.fu-berlin.de/diss/receive/FUDISS_thesis_000000105618).
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Pozios, I., Knösel, T., Zhao, Y. et al. Expression of phosphorylated estrogen receptor beta is an independent negative prognostic factor for pancreatic ductal adenocarcinoma. J Cancer Res Clin Oncol 144, 1887–1897 (2018). https://doi.org/10.1007/s00432-018-2717-2
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DOI: https://doi.org/10.1007/s00432-018-2717-2