Oestrogen receptor status in non-small-cell lung cancer in females: A study from North India

Abstract

Background: The frequency of oestrogen receptor (ER-β) positivity in non-small cell lung cancer (NSCLC), especially in women, its relationship to prognosis, and the potential to identify patients at high risk of cancer-related events have not been well studied. Methods: This study is a prospective single-centre study that included all women diagnosed with NCSLC admitted for bronchoscopic/CT-guided biopsy between August 2014 and August 2016. Smoking status was recorded and all patients were staged with TNM classification. Tumour samples were diagnosed by routine histopathology using WHO criteria and all had immunohistochemistry for ER-β performed. Samples were graded for reactivity. Findings: The study group comprised 38 women aged 56–65 years; median age was 60 years. Squamous cell carcinoma was more common (56%) than adenocarcinoma. Most patients were stage IIIa (55.26%) and stage IV (26.32%) at presentation. Oestrogen-receptor-positivity was seen in 18.42% of patients. ER-β expression was significantly higher in adenocarcinoma (29.41%) than in squamous cell carcinoma (9.5%). ER-β expression was higher in non-smokers (85.71%) than smokers (14.28%). Most ER-β-positive patients had stage IIIa (71%) disease, whereas 29% had stage IV disease. Median survival was 63 days. ER-β-positive patients had better survival (71.42%) than ER-β negative patients (odds ratio 19.35, p=0.001). Interpretation: In this study of female NSCLC patients, ER-β-reactive tumours tended to be present in non-smokers and those with adenocarcinoma histology. Patients with stage IIIa disease more commonly expressed ER-β than patients with higher-stage disease. ER-β-positive patients also had better survival than patients who were ER-β negative. Trials with anti-oestrogen-receptor protein drugs may benefit some patients with NSCLC. Funding: SKIMS institutional research grant. Conflicts of interest: We declare that we have no conflicts of interest.