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Differential expression of estrogen receptor beta (ERbeta) and its C-terminal truncated splice variant ERbetacx as prognostic predictors in human prostatic cancer.

Estrogens have been widely used for the treatment of advanced prostatic adenocarcinoma. However, their direct effect to prostatic cancer cells via estrogen receptors remains unclear. We investigated expression of ERalpha, wild-type ERbeta (wtERbeta), and a C-terminal truncated splice variant of ERbeta (ERbetacx) in 50 benign and 100 malignant human prostatic tissue samples by immunohistochemistry. While strong immunostaining of ERalpha was consistently identified in the stromal compartment, wtERbeta was expressed in epithelial cells in both the benign and malignant foci. However, wtERbeta expression was significantly lower in the cancers than in the benign epithelium and inversely correlated with Gleason tumor grade (P < 0.0001 and P = 0.0099, respectively). In contrast, ERbetacx was significantly more expressed in the high-grade cancers (83%) compared with the low-grade tumors (22%) and the benign sites (11%) (P < 0.0001, both). Cancer-specific survival of patients with lower wtERbeta expression was significantly worse than those with higher expression of wtERbeta (P = 0.0018). Conversely, higher ERbetacx expression significantly correlated with poor cancer-specific survival (P = 0.0058). These results suggest that differential expressions of wtERbeta and ERbetacx may be prognostic predictors for prostatic cancer.