Cross-talk between PI3K and estrogen in the mouse thyroid predisposes to the development of follicular carcinomas with a higher incidence in females

Abstract

It is well known that thyroid disease is more frequent in women than in men, however the molecular basis for this gender difference is still poorly understood. PI3K activation, through different mechanisms including loss of the PTEN tumor suppressor, is being increasingly recognized as a major player in the development of thyroid neoplastic lesions. Loss of Pten in the mouse thyroid results in a significant increase in the thyrocyte proliferative index, which is more prominent in the female mice. Here we show that 52% of the Pten−/− female mice, but only 12% of the males, develop follicular adenomas by one year of age. In addition, 50% of female mutants, but only 35% of males older than one year of age develop invasive, and often metastatic, follicular carcinomas. Mutant females have a significantly shorter overall survival compared to male mutants. Hormonal manipulation experiments established a direct role of estrogens in controlling the increased thyrocyte proliferation index in mutant females. Furthermore, while genetic ablation of one Cdkn1b allele accelerated the development of neoplastic lesions, it also abolished the gender differences in survival and reduced the difference in neoplastic lesion development rate, underlining a key role of p27 in mediating estrogen action in the thyroid follicular cells.These data, based on a clinically relevant model of thyroid follicular carcinoma, provide for the first time in vivo evidence that circulating estrogens are directly responsible for the increased female susceptibility to thyroid disease, at least upon activation of the PI3K pathway, and provide novel insights into the gender differences characterizing thyroid neoplastic disorders.