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Sex Steroid Hormone Receptors in Human Thymoma

Department of Pathology, Tohoku University School of Medicine (H.I., T.S., T.M., C.K., H.S.); Department of Thoracic Surgery, Institute of Development, Aging, and Cancer, Tohoku University (S.S., T.K.); and Department of Surgery, Sendai Kousei Hospital (M.H.), Sendai 980-8575, Japan; and Departments of Pathology (T.T.) and Thoracic Cardiovascular Surgery (H.I., M.S.), Graduate School, Tokyo Medical and Dental University, Tokyo 113-0034, Japan

Address all correspondence and requests for reprints to: Hironori Ishibashi, M.D., Department of Pathology, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi Prefecture, 980-8575, Japan. E-mail: hishiba{at}kf6.so-net.ne.jp.

In this study we examined the immunohistochemical localization of sex steroid receptors for estrogen (ER) and ERß, progesterone-A (PR-A) and PR-B, and androgen (AR) in human thymoma (n = 132) and correlated these findings with various clinicopathological parameters. We used RT-PCR and real-time PCR to further study the expression of these receptors in 20 thymoma cases. Immunoreactivity for all sex steroid receptors was detected in the nuclei of thymoma epithelial cells. The percentage of immunopositive cases and the H-score values for each receptor (mean ± SD) were: ER, 66% and 85.8 ± 80.2; ERß, 7% and 7.2 ± 8.7; PR-A, 4% and 2.7 ± 4.9; PR-B, 49% and 55.8 ± 68.3; and AR, 15% and 14.1 ± 11.7, respectively. The results of real-time PCR were consistent with those of immunohistochemistry, especially results for ER, PR-B, and AR. A significant positive correlation was detected between immunoreactivity for ER and PR-B. ER immunoreactivity was inversely correlated with tumor size, clinical stage, WHO classification, and Ki-67 labeling index. In addition, the status of ER immunoreactivity was significantly associated with a better clinical outcome in thymoma patients. Results from our study suggest that estrogens may inhibit thymoma growth via ER, and that ER immunoreactivity may act as a prognostic factor in human thymoma.

Abbreviations: AR, Androgen receptor; ER, estrogen receptor; GAPDH, glyceraldehyde-3-phosphate dehydrogenase; ir, immunoreactivity; LI, labeling index; PR, progesterone receptor.

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