Retrospective analysis shows estrogen and progesterone receptors impact aggressiveness in thyroid cancer, suggesting hormonal therapies may be beneficial.
Introduction/Objective Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy, with a prevalence three times higher in females than in males, particularly among women under the age of 50. The roles of estrogen receptors (ER) and progesterone receptors (PR) remain under-investigated. This research aims to evaluate the expression of hormonal receptors in PTC. Methods/Case Report This retrospective study included eight patients (seven females and one male) with surgically resected thyroid tumors, aged 36 to 88 years. Immunohistochemical staining was used to assess the expression of ER, PR, and the Ki-67 proliferation index. Results An association was found between hormonal receptor expression and tumor features in pre- and postmenopausal women. A 39-year-old female with classic PTC showed high ER expression (80%) . In addition, a 69-year-old female with encapsulated oncocytic PTC displayed low ER expression and moderate PR expression (25%). A 57-year-old male with classic PTC showed negligible ER, PR, and Ki-67 expression, suggesting that hormonal receptor activity may be less significant in males. However, the oldest patient, an 88-year-old female with infiltrative follicular PTC showed low ER and PR expression and a significantly elevated Ki-67 index (20%), indicating a more aggressive tumor behavior in the absence of hormonal receptor expression. Conclusion The data suggest that the increased prevalence of PTC in premenopausal women might be hormonally driven. The lack of hormonal receptor expression in elderly patients with more aggressive tumors resembles patterns seen in hormone-sensitive malignancies such as breast cancer, where hormone receptor negativity is associated with a more aggressive behavior. While the preliminary data suggest diagnostic and prognostic advantages for hormonal receptor expression, further research is needed to explore the potential for hormonal therapies in these patients.
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Bseiso et al. (2025) studied this question.
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