UAMS Medical Center
Sex Hormone Receptors Can Indicate More Aggressive Brain Tumors, Report UAMS Researchers
LITTLE ROCK – The presence or absence of receptors for sex hormones on the surface of a brain tumor can indicate if the tumor is more likely to recur or to grow aggressively, reported University of Arkansas for Medical Sciences (UAMS) researchers in the August issue of the Journal of Neurosurgery.
“Progesterone and estrogen receptors: opposing prognostic indicators in meningiomas” is the leading article in the issue Journal of Neurosurgery by the American Association of Neurosurgeons, which includes an editorial praising the work of the UAMS researchers.
Female sex hormones have been implicated in the growth of meningiomas – a form of usually benign brain tumor – from earlier observations that more women were diagnosed with these tumors, the acceleration of tumor growth during pregnancy and an association with breast cancer, the article said. Progesterone and estrogen are hormones usually associated with females but are also present in males.
“Our report shows that recurrence is less likely with the presence of progesterone receptors,” said Ossama Al-Mefty, M.D, professor and chairman of the Department of Neurosurgery in the UAMS College of Medicine and an internationally known expert in the treatment of skull-based tumors. “Sex hormone receptor status should be routinely studied for its prognostic value.”
The 11-year UAMS study of more than 230 patients with the brain tumor showed that the presence or lack of receptors – molecules in a cell that attach to certain substances and change the nature of the cell – for the hormones estrogen and progesterone had a bearing on the patient’s prognosis.
Receptors for progesterone usually signaled a favorable outcome for patients. A lack of either type receptor or the presence of estrogen receptors correlated with more aggressive tumor growth as well as an increased risk of recurrence.
Svetlana Pravdenkova, M.D., Ph.D., research assistant professor in the Department of Neurosurgery, is the lead author of the article. Contributors include Al-Mefty; Jeffrey Sawyer, Ph.D., professor of pathology in the College of Medicine and director of the UAMS Cytogenetics Laboratory; and Muhammad Husain, M.D., associate professor of pathology in the College of Medicine.
The patients in the study, which included men and women, were divided into three groups: Group 1 with tumors that had progesterone receptors alone; Group 2 with tumors that lacked receptors for either hormone; and Group 3 with tumors that showed estrogen receptors either with or without progesterone receptors.
Just 10 percent of the patients with only progesterone receptors had tumors that showed aggressive growth, compared to 31 percent in Group 2 and 33 percent in Group 3. Only 5 percent of those in the first group had tumor recurrence, compared to 30 percent in Group 2 and 27 percent in Group 3.
The presence of progesterone receptors alone also was associated with less serious tumors, based on the World Health Organization tumor grading scale.
Al-Mefty said the study grew out of a continued examination of tumor genetics and whether a chromosomal abnormality correlated with tumor prognosis. He noted that in the study, chromosomal abnormalities occurred in all of the groups to varying degrees.
In an article published in the August 2004 Journal of Neurosurgery, a team of UAMS researchers led by Al-Mefty reported that meningiomas thought to be benign may show early signs of cancer at the genetic level.