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Abstract
The aim of this study is to evaluate the expression of estrogen receptors alpha in malignant and premalignant colorectal lesions. This prospective study was conducted from the period 2004 to 2006. The study included 70 patients who had an indication for colonoscopic examination and they were selected from those who were attending to Gastrointestinal Endoscopy and Liver Unit, in Kasr EL-Aini Hospital, Cairo University.
Their ages ranged between 8 & 79 years with a mean age of 43.5 years. They were 36 males (51.4%) and 34 females (48.6%) with male to female ratio nearly 1:1. Patients were categorized into four groups including 21 patients with colorectal cancer, 14 patients with adenomatous polyps, 15 patients with ulcerative colitis and 20 patients with normal colonoscopic findings as a control group.
All patients were subjected to: Full history taking and thorough clinical examination, stool analysis for ova and parasites, rectal snip for schistosomiasis, occult blood in stools, complete blood count and erythrocyte sedimentation rate, Carcino Embryonic Antigen (CEA), abdominal ultrasound and full colonoscopic examination. Biopsies from cancerous tissue, adenomatous polyps, inflammatory bowel disease and normal colonic mucosa were obtained endoscopically and examined by immunohistochemistry for ERα.
Immunohistochemical analysis of the samples revealed the presence of ERα in 35.8% of cases of colorectal adenomatous polyps, 4.7% of cases with CRC and absent in mucosa of IBD cases. ERα was also present in 10% of normal colorectal mucosa.
Statistical analysis between ERα positive and ERα negative adenoma cases shows no significant correlation between ERα positivity and age, sex, mean hemoglobin level, ESR and CEA level, the site, size, shape, and histopathological type of the polyp. However, there was a significant correlation between ERα positivity and the degree of dysplasia of adenomatous polyps. Statistical analysis showed that ERα is good predictor for adenomatous lesions.