title: Correlation between epidermal growth factor receptor mutations and nuclear expression of female hormone receptors in non-small cell lung cancer: a meta-analysis.
abstract: BACKGROUND
  Compared with male, female non-small cell lung cancer (NSCLC) patients have better response when treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs), suggesting a potential association between female hormones and EGFR mutation. However, the results provided by previous studies were inconclusive and controversial. We sought to examine the link between the expression of nuclear female hormone receptors and EGFR mutations in NSCLC.
  
  
  METHODS
  Electronic databases were used to search the relevant articles. The involved hormone receptors included estrogen receptor (ER) and progesterone receptor (PR). The primary endpoint was the occurrence of ER/PR expression and EGFR mutation in NSCLC patients.
  
  
  RESULTS
  Five studies fulfilled the criteria and were included in our analysis. Patients with high ER-β expression had higher positive EGFR mutation than low ER-β patients (44.2% vs. 23.7%), and there was a significant difference between the two groups [odds radio (OR) 3.44, 95% confidence interval (CI): 2.40-4.93, Z=6.72, P<0.001]. However, there is no significant correlation between EGFR mutations and ER-α (when included ER-α3, OR 1.20, 95% CI: 0.62-2.33, Z=0.55, P=0.58; and when included ER-α4, OR 1.18, 95% CI: 0.62-2.25, Z=0.51, P=0.61) or PR (OR 1.29, 95% CI: 0.40-4.10, Z=0.43, P=0.67). No significant publication bias was observed.
  
  
  CONCLUSIONS
  High nuclear expression of ER-β, but not ER-α or PR is correlated with EGFR mutations in NSCLC. The underlying mechanism and potential translational relevance warrant further investigation.
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Qihua
authors.initials: Q
authors.lastname: He
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Mingzhe
authors.initials: M
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Jiaxi
authors.initials: J
authors.lastname: He
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Shen
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Shengyi
authors.initials: S
authors.lastname: Zhong
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Long
authors.initials: L
authors.lastname: Jiang
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Chenglin
authors.initials: C
authors.lastname: Yang
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Minzhang
authors.initials: M
authors.lastname: Guo
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Xuewei
authors.initials: X
authors.lastname: Chen
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
authors.affiliation: 1 Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 3 Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen 361004, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
keywords: Non-small cell lung cancer (NSCLC); epidermal growth factor receptor (EGFR) mutation; estrogen receptor (ER); meta-analysis; progesterone receptor (PR)