Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;149(17):15795-15804.
doi: 10.1007/s00432-023-05348-z. Epub 2023 Sep 5.

Correlation between androgen and estrogen receptor expression and clinicopathologic features in carcinoma urinary bladder

Nikita Shrivastava  1 , Rahul Jena  1 , Gautam Ram Choudhary  2 , Priyank Bhargava  1 , Vikarn Vishwajeet  3 , Poonam Elhence  3 , Mahendra Singh  1 , Deepak Prakash Bhirud  1 , Arjun Singh Sandhu  1
Affiliations

Correlation between androgen and estrogen receptor expression and clinicopathologic features in carcinoma urinary bladder

Nikita Shrivastava et al. J Cancer Res Clin Oncol. 2023 Nov.

Abstract

Introduction: The molecular mapping of cancers by the Cancer Genome Atlas Project has accelerated the quest for new therapeutic targets for urinary bladder cancer, including sex steroid receptors. Previous studies have demonstrated conflicting results on their relationship with bladder cancer, and there is sparse data on their expression in the Indian population. The aim of our study is to examine the expression of androgen receptors (AR) and estrogen receptors (ERα and ERβ) in patients with bladder cancer and their correlation with clinicopathologic features.

Materials and methods: In this retrospective cohort study, a total of 132 patients, who were surgically managed for urinary bladder mass by transurethral resection or radical cystectomy in our institute, with transitional cell carcinoma on histopathology and with at least two years of follow-up were included. Their demographic and treatment details were obtained, histopathology blocks were retrieved and immunohistochemical staining for androgen and estrogen receptors was performed. Then, the relationship between their expression and clinicopathologic features was studied.

Results: A total of 3.79% of patients showed estrogen receptor alpha positivity, 51.52% estrogen receptor beta positivity and 63.64% androgen receptor positivity. No statistically significant correlation was found between age of patients (p = 0.75/0.52/0.87), tumour stage and grade (0.71/0.3/0.21), pathological variant (p = 1/0.58/0.38) and overall survival (p = 0.70/0.052/0.45 for NMIBC and p = 0.82/0.36/0.22) and estrogen receptor alpha, estrogen receptor beta and androgen receptor-positive status, respectively. Estrogen receptor beta positivity was significantly higher in patients with unifocal (p = 0.015) and small tumours (< 5 cm) (p = 0.03), and its expression was associated with better disease-free survival (DFS) (p = 0.046) in patients of non-muscle invasive bladder cancer (NMIBC).

Conclusion: Our study has the largest sample size conducted on Indian population with results differing from previous studies conducted on western population. Estrogen receptor beta expression was significantly associated with small unifocal tumours and better DFS. Estrogen receptor alpha and androgen receptor expression were not found to be associated with the clinicopathologic features of the study population.

Keywords: Androgen receptor; Estrogen receptor alpha; Estrogen receptor beta; Urinary bladder cancer.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Nuclear expression for sex steroid receptors in urinary bladder cancer in tumour cells [Immunohistochemistry, × 200]. (a) AR (b) ERβ (c) ERα
Fig. 2
Fig. 2
Kaplan–Meier survival analysis curve to find out overall survival rate in negative and positive (a) ERɑ, (b) ERβ and (c) AR in patients with NMIBC and overall survival rate in negative and positive (d) ERɑ, (e) ERβ and (f) AR in patients with MIBC and compare them with the log-rank test
Fig. 3
Fig. 3
Kaplan–Meier survival analysis curve to find out disease-free survival rate in negative and positive (a) ERɑ, (b) ERβ and (c) AR in patients with NMIBC and progression-free survival rate in negative and positive (d) ERɑ, (e) ERβ and (f) AR in patients with NMIBC and compare them with the log-rank test
See this image and copyright information in PMC

References

    1. An MH, Kim MS, Kim C, Noh TI, Joo KJ, Lee DH, Yi KH, Kwak JW, Hwang TH, Park RW, Kang SH (2023) Association of 5α-reductase inhibitor prescription with bladder cancer progression in males in South Korea. JAMA Netw Open 6(5):e2313667 - PMC - PubMed
    1. Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM, Dominguez Escrig JL et al (2022) European association of urology guidelines on non-muscle-invasive bladder cancer (Ta, T1, and carcinoma in situ). Eur Urol 81(1):75–94 - PubMed
    1. Bellmunt J, de Wit R, Vaughn DJ et al (2017) Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N Engl J Med 376(11):1015–1026 - PMC - PubMed
    1. Bolenz C, Lotan Y, Ashfaq R, Shariat SF (2009) Estrogen and progesterone hormonal receptor expression in urothelial carcinoma of the bladder. Eur Urol 56(6):1093–1095 - PubMed
    1. Boorjian S, Ugras S, Mongan NP et al (2004) Androgen receptor expression is inversely correlated with pathologic tumor stage in bladder cancer. Urology 64(2):383–388 - PubMed