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Expression of Estrogen and Progesterone Receptor in Tumor Stroma Predicts Favorable Prognosis of Cervical Squamous Cell Carcinoma
  1. Mun-Kun Hong, MD*,,,
  2. Jen-Hung Wang, MS§,
  3. Cheng-Chuan Su, MS,
  4. Ming-Hsun Li, MD,
  5. Yung-Hsiang Hsu, MS and
  6. Tang-Yuan Chu, PhD*,
  1. * Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital;
  2. School of Medicine, Tzu Chi University;
  3. Center for Prevention & Therapy of Gynecology Cancers, Buddhist Tzu Chi General Hospital;
  4. § Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien;
  5. Departments of Clinical Pathology and Anatomic Pathology, Buddhist Dalin Tzu Chi Hospital, Chiayi County;
  6. Department of Pathology, Buddhist Tzu Chi General Hospital; and Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, Republic of China.
  1. Address correspondence and reprint requests to Tang-Yuan Chu, MD, PhD, 707, Sec. 3, Chung Yang Rd, Hualien City, Hualien 970, Taiwan, Republic of China. E-mail: hidrchu{at}


Objectives The aim of this study was to investigate the expression of estrogen receptor α (ERα) and progesterone receptor B (PRB) in the stroma and carcinoma tissues of cervical cancer and their relationship to clinical characteristics and the status of human papillomavirus (HPV) infection.

Methods Expressional levels of ERα and PRB in tissue blocks of 95 cervical carcinomas were independently scored by 2 pathologists. Human papillomavirus DNA, viral load, and genotypes were determined by polymerase chain reaction. Clinical characteristics were reviewed from chart and cancer registry.

Results Estrogen receptor α and PRB were mainly expressed in the stroma but not in the carcinoma tissues of the cervical cancer, and their expressions were highly correlated. More stromal ERαs were found in early-stage tumors than in advanced-stage tumors. Greater stromal expressions of ERα and PRB were associated with a more favorable prognosis (P = 0.018 and P = 0.004, respectively). The expressions were not related to the differentiation of cancer, the status of HPV infection, the HPV load, or the genotype. In multivariate analysis, stromal ERα and PRB expressions were independently associated with a lower risk of mortality. The adjusted hazard ratios of mortality for low and high expressions of ERα were 0.19 (95% confidential interval [95% CI], 0.04–0.87) and 0.15 (95% CI, 0.03–0.81), respectively, whereas for low and high expressions of PRB hazard ratios were 0.46 (95% CI, 0.19–1.16) and 0.24 (95% CI, 0.06–0.96), respectively.

Conclusions This study showed that stromal ERα and PRB expressions are independent prognostic indicators of cervical squamous cell carcinoma.

  • Cervical cancer
  • Prognosis
  • Stromal estrogen receptor α
  • Stromal progesterone receptor B

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  • The authors declare no conflicts of interest.