Abstract
Background: incidence of Colorectal cancer (CRC) is increasing globally. In Egypt, CRC ranks the sixth most common cancer in males and the fifth in females. Aim: To assess the expression of estrogen receptors (alpha and beta) in pre-malignant (adenomatous polyps and IBD), malignant colorectal lesions and normal colonic mucosa in group of Egyptian patients. Methods: This prospective study was done on 45 patients presenting with colonic symptoms, patients were divided into four groups; 15 CRC patients, 10 patients with adenomatous polyps, 10 IBD patients and 10 patients in the control group. Patients subjected to: Stool analysis, FOBT, CBC, CEA, Abdominal ultrasound & colonoscopy and biopsy (number = 80), Pathological, immunohistochemistry and RT- PCR quantification of ERα and ERβ were done. Results: Mean age: 39.2 (12 - 73), gender: M/F: 28/17. Bleeding per rectum was the commonest presentation; 29/45 (64.4%). CEA was significantly elevated in the CRC group compared with other studied groups (1692 mg/L vs. 4.0, 4.0 and 4.4 mg/L). Ultrasonography of the studied patients showed that metastatic CRC: 3/15 (20%); Colonic wall thickening: 5/15 (33.3%), 1/10 showed colonic polypoidal lesions in adenomatous polyps groups, in IBD group: 4/10 (40%) showed colonic and ileocecal thicknening. All the studied patients showed negative results for estrogen receptors (alpha and beta) by the use of immunohistochemistry staining and RT-PCR technique. Conclusion: Role of estrogen receptors in the colonic mucosa, precancerous and colorectal cancer is doubtful, contradictory results with some literature data could be due to racial and genetic difference in the studied population.
Highlights
The incidence of colorectal cancer (CRC) is increasing globally [1], it is ranked as the 4th most common cancer in males and the 2nd for females [2]
Colorectal cancer (CRC) was responsible for 3.9% of all cancer related mortality and ranking in the seventh cause of cancer death [4]
ERβ is the dominant estrogen receptors (ER) isoform in normal colonic mucosa playing a key role in the mitogenic action of estrogens by providing protection against ERα induced hyper proliferation and the stimulation of apoptosis [6]
Summary
The incidence of colorectal cancer (CRC) is increasing globally [1], it is ranked as the 4th most common cancer in males and the 2nd for females [2]. It accounts for more than 655,000 deaths worldwide per year and it accounts for the third leading cause of cancer-related death in the Western world [3]. ERs can regulate gene expression without directly binding to DNA. This occurs through protein-protein interactions with other DNA-binding transcription factors in the nucleus. Membraneassociated ERs mediate nongenomic actions of estrogens, OPEN ACCESS
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