Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2018; 24(1): 1-4
Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.1
Estrogen, estrogen receptors, and hepatocellular carcinoma: Are we there yet?
Olga A Sukocheva
Olga A Sukocheva, School of Health Sciences, Flinders University of South Australia, Flinders Drive, Bedford Park 5042, Australia
Author contributions: The author of the manuscript, Sukocheva OA, conceived, designed, and drafted the submitted manuscript.
Conflict-of-interest statement: The author has no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Olga A Sukocheva, MSc, PhD, Academic Research, School of Health Sciences, Flinders University of South Australia, Flinders Drive, Bedford Park 5042, Australia. olga.sukocheva@flinders.edu.au
Telephone: +61-80478200062 Fax: +61-8-82012410
Received: November 14, 2017
Peer-review started: November 15, 2017
First decision: November 30, 2017
Revised: December 6, 2017
Accepted: December 12, 2017
Article in press: December 12, 2017
Published online: January 7, 2018
Abstract

A protective role of the sex steroid hormone estrogen in hepatocellular carcinoma (HCC) was suggested a few decades ago according to clinical data showing higher HCC morbidity and mortality among males. Several recent studies further confirmed the anti-cancer effects of estrogen in the liver. However, it remains to be identified how to exploit estrogen signalling within clinical settings for HCC treatment. There are several unresolved issues related to the estrogen pathway in liver cells. The main problems include the absence of a clear understanding of which estrogen receptor (ER) isoform is predominantly expressed in normal and malignant liver cells, the ER isoform expression difference between males and females, and which ER isoform should be targeted when designing HCC therapy. Some of those questions were recently addressed by Iyer and co-authors. The current editorial review critically analyses the study by Iyer et al (WJG, 2017) that investigated the expression of ER subtypes in liver samples collected from patients with a healthy liver, hepatitis C virus cirrhosis, and HCC. ER presence was evaluated in association with gender, intracellular localization, inflammation marker NF-κB, and proliferation-related effector cyclin D1. The study limitations and advantages are discussed in light of recent advances in the HCC and estrogen signalling areas.

Keywords: Hepatocellular carcinoma, Hepatitis C virus, Hepatitis, Estrogen receptors, Cirrhosis

Core tip: Recent discoveries confirmed that the female sex hormone estrogen protects against the development and progression of hepatocellular carcinoma (HCC). However, the mechanism of estrogen’s anti-oncogenic effects and the specific impact of estrogen receptor (ER) signalling in HCC are unclear and controversial. It is essential to determine how to exploit the estrogen signalling pathway within a clinical setting for HCC treatment. The current editorial review critically analyses the Iyer et al (WJG, 2017) study that investigated the expression of ER subtypes in liver samples collected from patients with a healthy liver, hepatitis C virus cirrhosis, and HCC.