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Estrogen receptors in prolactinomas: a clinico-pathological study
G J Kaptain1, N E Simmons, T D Alden
1Department of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA. gjk5c@virginia.edu
Pituitary
|November 18, 2000
Summary
Estrogen receptor (ER) expression is less common in recurrent pituitary tumors. This suggests antiestrogen therapy may be less effective for these specific cases.
Area of Science:
- Endocrinology
- Oncology
- Molecular Biology
Background:
- Antiestrogens are established treatments for estrogen receptor (ER)-positive breast cancer.
- The application of antiestrogen therapy in pituitary adenomas remains unexplored.
- This study aimed to identify patient groups potentially benefiting from antiestrogen therapy for pituitary adenomas.
Purpose of the Study:
- To investigate the prevalence of estrogen receptor (ER) expression in prolactinomas.
- To determine factors predicting ER expression in pituitary tumors.
- To assess the potential for antiestrogen therapy in pituitary adenoma treatment.
Main Methods:
- Immunohistochemistry was used to analyze ER and Ki-67 labeling index in 29 prolactinomas.
- Patient data included gender, age, menstrual status, and tumor characteristics (size, invasiveness, recurrence).
- Factors evaluated for prediction of ER expression included serum prolactin, Ki-67, and exposure to dopamine agonists.
Main Results:
- ER expression was observed in 60% of male and 90% of menstruating female tumors, versus 67% in amenorrheic women.
- No evaluated variable (gender, age, menstrual status, Ki-67, prolactin, tumor size, invasiveness) predicted ER presence.
- ER incidence was significantly lower in recurrent tumors (p = 0.03).
Conclusions:
- Recurrent pituitary tumors exhibit a reduced likelihood of estrogen receptor (ER) expression.
- The effectiveness of ER antagonists cannot be reliably predicted based on gender or estrogen exposure history.