Tissue microarray analysis of hormonal signaling pathways in uterine carcinosarcoma

Objectives: To evaluate the relationship of hormone (estrogen receptor α, estrogen receptor β, progesterone receptor) and growth factor receptor (insulin-like growth factor receptor, human epidermal growth factor receptor 2) expression with disease progression in uterine carcinosarcoma. Study Design: Immunohistochemistry was performed on tissue arrays using standard methodology. Differences between groups were evaluated by the Wilcoxon rank-sum test. Interactions between tumor stage and receptor expression were determined by linear trend analysis. Results: Compared with normal endometrium, carcinosarcomas exhibited low estrogen receptor α and progesterone receptor expression (all P < .01), but overexpressed estrogen receptor β (P = .02). Estrogen receptor β expression increased in advanced stage disease (P = .02). Insulin-like growth factor receptor expression was lower in carcinosarcoma compared with normal endometrium (P = .01). Human epidermal growth factor receptor 2 expression was elevated and increased with disease progression (P < .01). Conclusion: In uterine carcinosarcoma, estrogen receptor β expression is elevated and increases with disease progression, whereas estrogen receptor α and progesterone receptor are suppressed. Human epidermal growth factor receptor 2 expression is increased, whereas insulin-like growth factor receptor is lower than in normal endometrium. These data support a potential role for estrogen receptor β in disease progression via crosstalk with human epidermal growth factor receptor 2.