J Cancer 2020; 11(7):1693-1701. doi:10.7150/jca.41943 This issue

Research Paper

Estrogen Receptor, Progesterone Receptor, and HER2 Receptor Markers in Endometrial Cancer

Caifeng Wang1, Davis A. Tran2, Melinda Z. Fu2, Wei Chen1, Sidney W. Fu2✉, Xu Li1✉

1. Emergency Department, Clinical Laboratory, Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.
2. Department of Medicine (Division of Genomic Medicine), and Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

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Wang C, Tran DA, Fu MZ, Chen W, Fu SW, Li X. Estrogen Receptor, Progesterone Receptor, and HER2 Receptor Markers in Endometrial Cancer. J Cancer 2020; 11(7):1693-1701. doi:10.7150/jca.41943. Available from https://www.jcancer.org/v11p1693.htm

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Background: Endometrial cancer (EC) is a major gynecologic adenocarcinoma that arises from the endometrium. While the incidence of EC is on the rise worldwide, survivorship and clinical advancement have considerably lagged compared to other cancers. Given the sensitive nature of the endometrium and its high expression of hormone receptors, hormonal therapy has become a favorable alternative treatment compared to highly toxic chemotherapeutics and radiation therapy.

Methods: Clinical samples from patients diagnosed with EC were obtained. ER and PR staining were performed according to the S-P kit, and HER2 staining was carried out according to the UltrasensitiveTM S-P immunohistochemistry kit protocol. Chi-square analysis was conducted using the SPSS. P-values of less than 0.05 were taken as an a priori value for statistical significance.

Results: Immunohistochemical (IHC) analysis showed the overall positive expression rates of ER, PR, and HER2 to be 59.8%, 75.0%, and 71.1%, respectively. Significant co-expression was found among all three receptors, suggesting a cooperative, synergistic effect. More importantly, we found that ER expression was correlated with FIGO staging and cervical invasion, whereas PR expression was associated with histologic type. No clinicopathologic features were correlated with HER2 expression, but HER2 positivity was inversely associated with the degree of HER2 overexpression.

Conclusions: These results suggest that EC is a heterogeneous disease that may not conform to traditional, prototypically defined subtypes. The status of ER, PR, and HER2 receptors may have the potential to serve as prognostic indicators for EC, but further analysis is needed to ascertain their prognostic significance.

Keywords: Endometrial cancer, ER, PR, HER2