Comments on “Inhibition of estrogen actions in human gynecological malignancies: New aspects of endocrine therapy for endometrial cancer and ovarian cancer”

Abstract

Dear Prof. Huhtaniemi,Editor in Chief of Molecular and Cellular Endocrinology.We have read with great interest the recently published paperby Ito and co-workers (Ito et al., 2011) on the contribution of estro-gen metabolism to endometrial and ovarian cancers. The studythoroughly reviews clinical investigations and trials testing hor-mone treatments for these disorders and underscores the transla-tional potential of our current knowledge for future possibletherapeutic applications.Given the potential impact of this study for the readers of‘Molecular and Cellular Endocrinology’, we would like to draw theauthor’sandeditor’sattentiontothefactthat,withrespecttoendo-metrial cancer, and specifically to the role of the 17b-hydroxyster-oid dehydrogenase type 1 (17b-HSD type 1), the proposed model(illustratedinFig.1Boftheaforementionedpaper)isnotuptodate.After reviewing selected publications (Casey et al., 1994; Itoet al., 2001; Utsunomiya et al., 2001), the authors conclude that17b-HSD type 1 is not expressed in normal, hyperplastic or malig-nant endometrium. However, a number of other studies have beenpublishedthat did report expression of 17b-HSD type1 in endome-trial cells, in normal endometrium and in endometrial pathologicalconditions, including endometrial cancer. Smuc and co-workers(Smuc et al., 2006) reported that 17b-HSD type 1 mRNA could bedetected in endometrial biopsies (normal and cancer) as well asin endometrial cancer Ishikawa cells (Ito and co-workers cite thispublication in their review but they decided to disregard the17b-HSD type 1 data shown in the same paper). In a later study,the same authors (Smuc and Rizner, 2009) have detected17b-HSD type 1 expression in a larger group of endometrial cancerbiopsies and controls and – in two additional studies – amongendometriosis patients and controls (Smuc et al.,2007, 2009). Type117b-HSD expression was reported independently by severalother investigators in normal endometrium (Maentausta et al.,1991; Miettinen et al., 1996), in endometrial cancer (Lepineet al., 2010), in endometrial hyperplasia (Bacallao et al., 2008), inprimary endometrial cells (Aghajanova et al., 2009), in endometri-osis (Zeitoun et al., 1998), in endometrial cancer cell lines (Fournierand Poirier, 2009; Laplante et al., 2009) and in transplanted humanendometrial tissue (Fechner et al., 2007).In conclusion, we are aware that the expression of type 117b-HSD in endometrial cells is low compared to other tissuesand it can be easily overlooked if not sensitive enough assays areused. However, although based on the available published litera-ture a clear role for this enzyme in endometrial cancer has yet tobe established, its expression, in endometrium and endometrialpathologies including cancer cannot be neglected.Yours Sincerely,Andrea RomanoGerard A.J. DunselmanJohannes L.H. EversRoy F.P.M. KruitwagenGROW: School for Oncology and Developmental Biology,Dept. of Obstetrics and Gynaecology,Maastricht University Medical Centre, The NetherlandsE-mail address: a.romano@maastrichtuniversity.nl (A. Romano)Available online 22 August 2011References