Hormonal receptors in lung adenocarcinoma: expression and difference in outcome by sex

// Rossana Berardi 1 , Francesca Morgese 1 , Alfredo Santinelli 2 , Azzurra Onofri 1 , Tommasina Biscotti 2 , Alessandro Brunelli 3 , Miriam Caramanti 1 , Agnese Savini 1 , Mariagrazia De Lisa 1 , Zelmira Ballatore 1 , Cecilia Pompili 3 , Michele Salati 4 , Paola Mazzanti 1 , Mariangela Torniai 1 , Stefano Cascinu 1, 5 1 Medical Oncology Unit, Universita Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy 2 Section of Pathological Anatomy and Histopathology, Deparment of Neuroscience, Universita Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy 3 Department of Thoracic Surgery, St. James’s University Hospital, Leeds, UK 4 Thoracic Surgery, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy 5 Actual Position: Oncologia Medica-Universita degli studi di Modena e Reggio Emilia Modena, Italy Correspondence to: Rossana Berardi, email: r.berardi@univpm.it Keywords: non-small cell lung cancer, gender differences, androgen receptor, estrogen receptor, progesterone receptor Received: November 01, 2015     Accepted: September 12, 2016     Published: September 26, 2016 ABSTRACT Background: Lung cancer seems to have different epidemiological, biomolecular and clinical characteristics in females than in males, with a better prognosis for women. The aim of the study is to determine gender differences in lung adenocarcinoma in terms of androgen (AR), estrogen (ER)α and progesterone (PgR) receptors expression and their impact on outcome. Results: Overall survival was significantly better in ERα and in PgR positive lung adenocarcinoma patients (median survival 45 vs. 19 months). Eight out of 62 patients showed positive expression of nuclear (n) AR and 18 of cytoplasmic (c) AR with a significantly better survival (49 vs. 19 and 45 vs. 19 months, respectively). There was a significant difference in survival between patients with vs. without c-AR expression (30 vs. 17 months). Finally, in the subgroup of women, median survival was greater in positive expression of c-AR than for women with negative c-AR (45 vs. 21 months). Materials and Methods: We conducted an analysis on a cohort of 62 patients with advanced NSCLC treated at our institution. We investigated the immunohistochemical expression of n/c AR, ERα and PgR in 62 NSCLC and we correlated it with patients’ clinic-pathologic characteristics and with prognosis. Conclusions: Our results showed that the positive expression of one hormonal receptor could represent a prognostic factor. Furthermore our study suggests that AR should become object of close examination in a larger series of lung adenocarcinoma patients, also for selection of the patients with best prognosis that can perform more chemotherapy lines.