Investig Clin Urol.  2018 Jul;59(4):232-237. 10.4111/icu.2018.59.4.232.

Role of co-expression of estrogen receptor beta and Ki67 in prostate adenocarcinoma

Affiliations
  • 1Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia. nazirah@ums.edu.my
  • 2Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia.
  • 3Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Abstract

PURPOSE
To evaluate the expression of estrogen receptor (ER)-beta and Ki67 in prostate cancer and study their relationship.
MATERIALS AND METHODS
We analyzed 101 cases of prostate adenocarcinoma diagnosed from January 2011 to June 2015 in 100 patients. Immunohistochemical staining of ER-beta and Ki67 was analyzed according to Gleason score categorized into prognostic groups of 1 to 5. Double-immunofluorescent staining of ER-beta and Ki67 was performed in a total of 20 cases to study the co-expression and the relationship between these markers within the same tumor.
RESULTS
A total of 53 of 101 cases (52.5%) were positive for ER-beta expression. There was a positive correlation whereby a high percentage of ER-beta expression was seen in the higher prognostic groups (groups 4 and 5; p=0.007). High Ki67 expression was observed in the higher prognostic group, whereas low Ki67 or negative expression was found in the lower prognostic group (p<0.001). The majority of cases evaluated with double-immunofluorescent staining (14/20) showed co-expression of ER-beta and Ki67 at the individual cell level.
CONCLUSIONS
ER-beta and Ki67 are independent tumor markers in high prognostic groups. Hence, co-expression of ER-beta and Ki67 indicates a more aggressive tumor with a poorer prognosis.

Keyword

Estrogen receptor beta; Ki-67 antigen; Neoplasm grading; Prostate neoplasms

MeSH Terms

Adenocarcinoma*
Biomarkers, Tumor
Estrogen Receptor beta*
Estrogens*
Humans
Ki-67 Antigen
Neoplasm Grading
Prognosis
Prostate*
Prostatic Neoplasms
Biomarkers, Tumor
Estrogen Receptor beta
Estrogens
Ki-67 Antigen

Figure

  • Fig. 1 Strong positive staining pattern for estrogen receptor beta (immunohistochemical staining, ×20).

  • Fig. 2 Low Ki67 staining pattern. Strong positive staining pattern for estrogen receptor beta (immunohistochemical staining, ×10).

  • Fig. 3 High Ki67 staining pattern. Strong positive staining pattern for estrogen receptor beta (immunohistochemical staining, ×20).

  • Fig. 4 Pattern of estrogen receptor (ER)-beta expression in relation to prognostic group.

  • Fig. 5 Pattern of Ki67 proliferation rate in relation to prognostic group.

  • Fig. 6 Double-immunofluorescent staining (×40) showing cells with positive co-expression for estrogen receptor (ER)-beta and Ki67 stained yellow (yellow arrow) while some proliferating cells not expressing ER-beta are stained green (green arrows) and some ER-beta positive cells that are not proliferating are stained red (red arrows).


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