Roles of Sex Hormones their Receptors in Carcinogenesis of Esophageal Squamous Cell Carcinoma from High-incidence Area of Esophageal Cancer

[Purpose] To explore roles of sex hormones and their receptors in the occusion,differentiation and metastasis of esophageal squamous cell carcinoma(ESCC) from high-incidence area(HIA) for esophageal cancer.[Methods] RIA was used to determine serum sex hormone levels of patients with ESCC from HIA(n=44) and age-matched asymptomatic population from low-incidence area(LIA)(n=60) and HIA(n=60).Seventy-two specimens of young ESCC patients(≤40 years old) collected from HIA hospital were analyzed for ER expression by immunohistochemistry for ER.[Results] Serum estradiol levels of male asymptomatic population from LIA,male asymptomatic population from HIA and male ESCC patients from HIA were 70.500±11.300pg/ml,54.684±18.159pg/ml,42.330±16.016pg/ml,respectively;serum estradiol levels of female asymptomatic population from LIA,female asymptomatic population from HIA and female ESCC patients from HIA were 87.010±13.910pg/ml,52.044±21.790pg/ml,32.998±19.339pg/ml,respectively;serum estradiol level of asymptomatic population from LIA was significantly higher than those in asymptomatic population from HIA and ESCC patients from HIA(P values of male were 0.001,0.001,respectively,P values of female were 0.0183,0.001,respectively).Serum testosterone levels of male asymptomatic population from LIA,male asymptomatic population from HIA and male ESCC patients from HIA were 4.100±1.500ng/ml,5.485±2.485ng/ml,5.555±2.648ng/ml,respectively;serum testosterone levels of female asymptomatic population from LIA,female asymptomatic population from HIA and female ESCC patients from HIA were 0.618±0.076ng/ml,1.795±0.959ng/ml,1.985±0.990ng/ml,respectively;serum testosterone level of asymptomatic population from LIA was lower than those in asymptomatic population from HIA and ESCC patients from HIA(P values of male were 0.0457,0.001,respectively,P values of female were 0.001,0.001,respectively).In the young ESCC patients,the expressions of ER in the group with high differentiations,with middle differentiations and with low differentiations were 65%,54%,37%,respectively(P=0.0684);the positive rates of ER in the group with positive lymph node metastasis and with negative lymph node metastasis were 44%,58%,respectively(P=0.3450);the positive rates of ER in the groups with tumor invasion underlayer of mucous membrane-muscular layer and with tumor invasion fibrous membrane were 42%,53%(P=0.5368).While the expressions of ER in stage ⅠandⅡ and in stage Ⅲ were 66%,35%,respectively(P=0.0176).[Conclusion] Relative low estrogen level,high androgen level and ratio alteration of sex hormones maybe important risk factors for esophageal carcinoma relating to carcinogenesis and prognosis.Therefore the combined determination of sex hormone levels and their receptor levels may provide more insight into the association between sex hormones and ESCC.