title: Expression levels of estrogen receptor beta in conjunction with aromatase predict survival in non-small cell lung cancer.
abstract: Estrogen signaling pathways may play a significant role in the pathogenesis of non-small cell lung cancers (NSCLC) as evidenced by the expression of aromatase and estrogen receptors (ERα and ERβ) in many of these tumors. Here we examine whether ERα and ERβ levels in conjunction with aromatase define patient groups with respect to survival outcomes and possible treatment regimens. Immunohistochemistry was performed on a high-density tissue microarray with resulting data and clinical information available for 377 patients. Patients were subdivided by gender, age and tumor histology, and survival data was determined using the Cox proportional hazards model and Kaplan-Meier curves. Neither ERα nor ERβ alone was predictor of survival in NSCLC. However, when coupled with aromatase expression, higher ERβ levels predicted worse survival in patients whose tumors expressed higher levels of aromatase. Although this finding was present in patients of both genders, it was especially pronounced in women ≥ 65 years old, where higher expression of both ERβ and aromatase indicated a markedly worse survival rate than that determined by aromatase alone. Expression of ERβ together with aromatase has predictive value for survival in different gender and age subgroups of NSCLC patients. This predictive value is stronger than each individual marker alone. Our results suggest treatment with aromatase inhibitors alone or combined with estrogen receptor modulators may be of benefit in some subpopulations of these patients.
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
authors.forename: Vei
authors.initials: V
authors.lastname: Mah
authors.forename: Diana
authors.initials: D
authors.lastname: Marquez
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alavi
authors.forename: Erin L
authors.initials: EL
authors.lastname: Maresh
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Nam
authors.initials: N
authors.lastname: Yoon
authors.forename: Steve
authors.initials: S
authors.lastname: Horvath
authors.forename: Lora
authors.initials: L
authors.lastname: Bagryanova
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fishbein
authors.forename: David
authors.initials: D
authors.lastname: Chia
authors.forename: Richard
authors.initials: R
authors.lastname: Pietras
authors.forename: Lee
authors.initials: L
authors.lastname: Goodglick
mesh_terms: D000368:Aged; D001141:Aromatase / Q000235:genetics / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D047629:Estrogen Receptor beta / Q000235:genetics / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012907:Smoking; D016019:Survival Analysis
chemical_list: D047629:Estrogen Receptor beta; D001141:Aromatase