Well-differentiated endometrial adenocarcinomas and poorly differentiated mixed mullerian tumors have altered ER and PR isoform expression

Both the estrogen receptor (ER) and the progesterone receptor (PR) have two subtypes: ER-alpha and beta, and PR-A and -B, respectively. These subtypes differ in function and expression, and recent reports have correlated chan ges in the normal proportions of these isoforms with neoplastic states. We investigated ER and PR isoform expression in normal pre- and post-menopausa l endometrium, well-differentiated endometrial adenocarcinoma, and poorly d ifferentiated malignant mixed mullerian tumors (MMMTs). Semi-quantitative R T-PCR and immunoblotting were used to measure receptor mRNA and protein exp ression. Estrogen receptor-alpha/beta mRNA ratios were significantly higher in postmenopausal (27.3) compared to premenopausal endometrium (4.9) mainl y as a result of lower ER-beta expression in the former. Compared to age-ma tched postmenopausal controls, the ER-alpha/beta ratio was reduced in both grade I adenocarcinoma and MMMT specimens (3.3 and 6.8, respectively), due to a selective loss of ER-alpha. The relative abundance of PR-A and PR-B mR NA remained unchanged between all tissue subtypes. Total PR protein, howeve r, was significantly reduced in MMMTs compared to all other groups. Thus, s ex steroid receptor expression is significantly and differentially altered in well-differentiated and poorly-differentiated endometrial cancers. Both cancers exhibit decreased ER-alpha expression and the MMMTs also demonstrat e a significant loss of PR protein.