van Halteren Henk, Mulder Dries, Ruijter Emiel
Department of Internal Medicine, Admiraal de Ruijter Hospital, Goes, the Netherlands.
Histopathology. 2013 Dec 3. doi: 10.1111/his.12340.
Oestrogen receptor-beta (ER-β) is expressed in colorectal cancer. Theoretically, ER-β stimulation could slow down tumour proliferation, and this is supported by preclinical research data. While preparing a Phase II trial for advanced colorectal cancer patients we performed a pilot study with three questions: (i) in what percentage of patients do metastases display strong ER-β1 expression; (ii) is there any concordance in expression between primary tumours and metastases; and (iii) is the immunohistochemical (IHC) scoring procedure reproducible?
Thirty patients were selected, 15 with locoregional lymph node metastases and 15 with either synchronous or metachronous hepatic metastases. All primary tumours and metastases were analysed for immunohistochemical ER-β1 expression according to a predefined scoring system. The scoring was performed independently by two pathologists in order to calculate the weighted kappa value. Strong ER-β1 expression was found in four of 15 hepatic metastases and four of 15 lymph node metastases. In 15 of 30 patients, the level of ER-β1 expression in the metastasis was concordant with that observed in the primary tumour. Weighted kappa values of IHC ER-β1 expression were satisfactory.
In twenty-five per cent of patients there was strong ER-β1 expression in metastases, biopsy of which will be considered mandatory for trial inclusion.
雌激素受体-β（ER-β）在结直肠癌中表达。理论上，ER-β刺激可减缓肿瘤增殖，临床前研究数据支持这一点。在为晚期结直肠癌患者准备一项II期试验时，我们进行了一项先导研究，有三个问题：（i）转移灶中ER-β1强表达的患者占比多少；（ii）原发性肿瘤和转移灶之间的表达是否存在一致性；（iii）免疫组织化学（IHC）评分程序是否可重复？
选取30例患者，15例有局部区域淋巴结转移，15例有同时性或异时性肝转移。根据预定义的评分系统对所有原发性肿瘤和转移灶进行免疫组织化学ER-β1表达分析。由两名病理学家独立进行评分，以计算加权kappa值。在15例肝转移灶中有4例、15例淋巴结转移灶中有4例发现ER-β1强表达。在30例患者中的15例，转移灶中ER-β1表达水平与原发性肿瘤中观察到的一致。IHC ER-β1表达的加权kappa值令人满意。
25%的患者转移灶中有ER-β1强表达，对于试验入组，将考虑对其进行活检。
