Role of Hormone Receptor Expression in Patients With Advanced-Stage Lung Cancer Treated With Chemotherapy

Abstract

BackgroundEvidence that supports a role for hormonal status in lung cancer has been inconsistently reported and is still unclear. We retrospectively assessed the potential correlation between sex-linked hormone receptor expression and the clinical outcome of patients with advanced-stage lung cancer treated with chemotherapy. Patients and MethodsBased on tissue availability, 130 consecutive patients diagnosed at San Luigi Hospital from January 2008 to June 2010 were collected, including 24 small-cell lung cancer, 57 adenocarcinomas, 34 squamous cell carcinomas, 5 large-cell carcinomas, and 10 non–small-cell lung cancer–not otherwise specified. The immunohistochemical expression of estrogen receptors (ER-α and ER-β) and progesterone receptor, aromatase, epidermal growth factor receptor (EGFR), and excision repair cross-complementing 1 (ERCC1) was assessed. ResultsER-β nuclear expression was higher than ER-α and progesterone receptor, whose expression was null or weak (mainly in women). ER-β expression was significantly higher in patients with metastatic disease compared with all other disease stages (P = .02). EGFR expression was strongly correlated with non–small-cell lung cancer histology, being higher in squamous types and stage related. In men, aromatase positive cases had a worse outcome (P = .03) as well as in men with non–small-cell lung cancer and high ER-β expression. In the latter group, the combined aromatase negative and/or low ER-β expression and low ERCC1 and/or low ER-β expression showed a better outcome (P = .026; P = .03, respectively). ConclusionIn patients with advanced-stage lung cancer treated with chemotherapy, the prognostic and predictive role of sex-linked hormone receptor expression, if any, is of borderline significance and is restricted to selected subgroups of patients.