Immunohistochemical Expression of Hormone Receptors in Melanoma of Pregnant Women, Non-Pregnant Women and Men: A Comparison Study
Jane H Zhou, Kevin B Kim, Patricia Fox, Jeffrey N Myers, Victor G Prieto. University of Texas MD Anderson Cancer Center, Houston, TX
Background: In melanoma, the significant survival advantage of female gender and reports of both accelerated progression and improved prognosis in pregnancy have lead to studies of the effect of hormones and hormone receptors, but the results have been inconclusive. We examined the immunohistochemical expression of Estrogen Receptor α, Estrogen Receptor β and Androgen Receptor in melanoma of pregnant women, non-pregnant women and men.
Design: Archival paraffin embedded melanoma tissue from 18 pregnant women, 18 non-pregnant women and 18 men at MD Anderson Cancer Center (MDACC) from 1996 to 2011 was used. The non-pregnant women and men patients were stage-matched and age controlled to the pregnant patients. All patients were 20–45 years old at the time of diagnosis. Follow-up was from the initial date of diagnosis to death or the last follow up at MDACC until the end of July 2012. The immunohistochemical study was performed using the Bond Max automated system of Leica Microsystems (Buffalo Grove, IL) according to the manufacture's protocol. The exact McNemar's test was used for the analysis of ERβ expression between the pregnant group and the control groups. Fisher's exact and Wilcoxon rank sum tests were used to assess the association between ERβ expression and Breslow thickness, primary tumor site, primary tumor or metastasis, and the stage of disease.
Results: There were 22 cases expressing ERβ: 10 (56%) of pregnant women, 7 (39%) of non-pregnant women, and 5 (29%) of men. The percentage of tumor cells positive ranged from 30% to more than 90%. Only 2 cases expressed ERα, one pregnant woman and one man. Both patients had acral lentiginous type melanoma in the toe. None of the cases expressed AR. Statistical analysis showed a trend that ERβ was more likely to be expressed in pregnant patients than in the male patients (p=0.073). There was no significant difference between pregnant and non-pregnant women (p=0.539). There was no association between ERβ expression and Breslow thickness, primary tumor site, primary tumor or metastasis, and the stage of disease.
Conclusions: Marginal evidence suggests that ERβ is more frequently expressed in pregnant patients than in male patients. The small sample size may have limited the statistical power of the study. A large-scale study is needed to look into the expression of ERβ in melanoma and its association with survival.
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 48, Tuesday Morning