Stains & CD markers
Estrogen receptor
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Estrogen receptor [title]
Estrogen receptor
Author: Nat Pernick, M.D.
Last author update: 1 June 2005
Last staff update: 12 August 2022
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Estrogen receptor [title]
Table of Contents
Definition / general | Interpretation | Uses by pathologists | Microscopic (histologic) images | Positive staining - disease | Negative staining | Additional referencesCite this page: Pernick N. Estrogen receptor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsER.html. Accessed March 22nd, 2023.
Definition / general
- See also Breast malignant topic
- Two subtypes: ER-alpha and ER-beta
- ER-alpha:
- "Classic" functions of ER
- May render breast epithelium susceptible to proliferative stimulation of estrogen
- Expressed in breast and endometrium
- ER-beta:
- "Housekeeping" functions
- Expressed in normal ovary and granulosa cells
- Carcinoma of breast, colon, prostate
- Both alpha and beta share highly conserved DNA binding domain and commonly interact with estrogen-regulating factors, but may affect different genes
- Presence of estrogen (type alpha) and progesterone receptors correlates best with response to anti-estrogen treatment (tamoxifen or others) or chemotherapy, only weakly with prognosis
- Presence is associated with better differentiated tumors, older age
- Evaluate % of tumor nuclei stained and intensity of staining (none, weak, moderate, strong)
- Immunostaining now done on paraffin fixed tissue (previously required fresh tissue)
- Metastases to skin are often positive for androgen receptor, even if ER-, PR- (Mod Pathol 2000;13:119)
- Antigen retrieval techniques are required for ER if glyoxal fixative is used (Hum Pathol 2004;35:1058)
- Compared to ER, PR staining adds only a limited amount of additional predictive information for response to hormonal therapy (Mod Pathol 2004;17:1545)
Interpretation
- Nuclear stain
- Cytoplasmic staining only is typically considered a negative result (Clin Cancer Res 2012;18:118, Appl Immunohistochem Mol Morphol 2017;25:313)
Uses by pathologists
- In breast cancer, predicts response to tamoxifen or other anti-estrogens
- Also prognostic marker for survival (ER+ is favorable)
- Relatively specific for breast origin (but numerous exceptions)
- Distinguishes endocervical (ER-) from endometrial (ER+) adenocarcinomas (Am J Surg Pathol 2002;26:998)
Microscopic (histologic) images
Contributed by Jijgee Munkhdelger, M.D., Ph.D. and Andrey Bychkov, M.D., Ph.D.
Breast, mucinous carcinoma
Breast tubular adenoma immunoprofile
Contributed by Leica Microsystems
Invasive ductal carcinoma, intense nuclear staining
Positive staining - disease
- Breast carcinoma (varies by subtype and tumor grade) - well differentiated tumors are typically positive
- Endometrial adenocarcinoma (75%)
- Ovarian serous, mucinous and endometrioid adenocarcinoma (Am J Surg Pathol 2001;25:667), papillary urothelial carcinoma of bladder (10 - 20%) and ovarian transitional cell carcinoma (90%, Arch Pathol Lab Med 2005;129:194)
Negative staining
- Endocervical adenocarcinoma, ovarian clear cell carcinoma
Additional references
