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However, its role in connection with the balance and ratio between ER\u03b1 and ER\u03b2 protein in papillary thyroid cancer (PTC) remains unclear. Here, we found that ER\u03b1 and ER\u03b2 were co-expressed in human PTC tissues and cells. ER\u03b1 promoted and ER\u03b2 inhibited the proliferation, invasion and migration of PTC cells. PES1 modulated the balance between ER\u03b1 and ER\u03b2 by elevating the ER\u03b1 protein level and simultaneously reducing the ER\u03b2 protein level, then upregulating the ER\u03b1\/ER\u03b2 protein ratio and promoting the proliferation, invasion and migration of PTC cells. In PTC tissues, PES1 protein level was positively correlated with the ER\u03b1 protein level and negatively correlated with the ER\u03b2 protein level. The PES1 and ER\u03b1 protein levels were gradually increased and the ER\u03b2 protein level was decreased by degree in the occurrence and development of PTC. Increased PES1 and ER\u03b1 protein levels and decreased ER\u03b2 protein level were correlated with the aggressive behaviors of PTC patients such as large tumor size, extrathyroidal extension (ETE), lymph node metastasis (LNM), high BRAFV600E expression and high TNM stage. It is suggested that PES1 promotes the occurrence and development of PTC by elevating the ER\u03b1 protein level and reducing the ER\u03b2 protein level, and then upregulating the ER\u03b1\/ER\u03b2 protein ratio.<\/jats:p>","DOI":"10.1038\/s41598-018-37648-7","type":"journal-article","created":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T11:04:33Z","timestamp":1548932673000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["PES1 promotes the occurrence and development of papillary thyroid cancer by upregulating the ER\u03b1\/ER\u03b2 protein ratio"],"prefix":"10.1038","volume":"9","author":[{"given":"Yi-Bo","family":"Qiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Yao","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin-Wan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-9093","authenticated-orcid":false,"given":"George G.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Min","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,1,31]]},"reference":[{"key":"37648_CR1","doi-asserted-by":"publisher","first-page":"T273","DOI":"10.1530\/ERC-14-0053","volume":"21","author":"M Derwahl","year":"2014","unstructured":"Derwahl, M. & Nicula, D. 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