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Background: Cervical cancer is the fourth most common cancer in the world and the second leading cause of mortality in India after breast cancer. Human papilloma virus (HPV) infection has been regarded as a key risk factor in cervical cancer, however it is not sufficient in the causation of the disease. Role of other cofactors like steroids and their receptors in the pathogenesis of carcinoma cervix is being studied extensively. Various in-vitro and some human studies have postulated a role of estrogen receptors in carcinoma cervix. Estrogen receptors (ER) were categorized into two subgroups (alpha and beta) after the discovery of estrogen receptor beta in the mid-nineties. Studies show that ER alpha (ERα) and beta (ERβ) have their own unique cell specific expression patterns and actions and may also have mutual antagonistic roles if present in the same tissue.
Aim and Objectives: The aim of the research was to study and compare the expression of ER alpha and beta in ectocervix of healthy women and cervical cancer patients.
Materials and Methods: One gram of cervical issue was taken from 30 cervical cancer patients and 20 healthy women and subjected to immune histochemical analysis. The expression pattern of ER alpha and beta was studied in terms of number of women expressing the receptor and immunoreactivity scores and compared between healthy and cancerous cervix.
Results: Ectocervical cells of both normal and cancerous cervix expressed both ER alpha (ERα) and beta (ERβ) in their nuclei and only ER beta in their cytoplasm. Ninety percent of healthy women expressed ER alpha in the ectocervix compared to only 6.67% of cervical cancer patients (p=0.000). The mean immunoreactivity scores for ER alpha expression was also lower in cervical cancer patients (0.167±0.75) compared to healthy women (2.60±2.01) [p=0.000].
Conclusion: ER alpha and beta have different expression patterns in ectocervical cells. ER alpha is significantly down expressed while ER beta expression is retained or slightly increased in cervical cancer cells when compared to normal cervix.
Keywords: Cervical cancer; Estrogen Receptor; Immunoreactivity