Steroid Hormone Receptor Expression and Survival in Lung Cancer
SM Sitterding, M Tretiakova, L Faoro, R Salgia, S Conzen, AN Husain, T Krausz. University of Chicago, Chicago, IL
Background: Steroid hormone receptor expression is used in the treatment of solid tumors and often correlates with patient outcome. For example, estrogen receptor (ER) reactivity of some lung cancers predicts poor survival. Glucocorticoids (GCs) are produced during physiologic stress and have medical utility for their immunosuppressive and anti-toxic effects as well as for the treatment of ALL. Studies in solid tumor cell lines have demonstrated that GCs inhibit growth and in some non-small cell lung cancers (NSCLC) GCR expression correlates with good outcome. However, in vitro studies illustrate that GCs antagonize chemotherapy-induced apoptosis; thus, the role of GCR expression and GC therapy remains unclear. Our study examines the expression of steroid hormone receptors in primary lung carcinomas and correlates these data with patient survival.
Design: Tissue microarrays (TMAs) of archived primary lung tumors from the University of Chicago, created after IRB approval, include 59 adenocarcinomas (AdCa), 48 squamous cell (SqCC), 47 small cell (SmCC), and 42 large cell carcinomas (LCC). Each TMA was stained with ERalpha, ERbeta, androgen receptor, and GCR. Scoring of each immunohistochemical stain was based on the Reiner 4-tiered system incorporating combined scores of intensity and percent of nuclei staining (score 0-3).
Results: GCR levels were highest in AdCas while SmCCs showed significantly lower scores. In patients with NSCLC, no significant difference in survival was seen based on low vs high GCR expression. However, in patients with SmCC, high expression of GCR correlated with better survival (8/9, 89% alive at a mean of 1 year) compared to those with low expression of GCR (11/32, 34% alive at a mean of 1 year).
Conclusions: GCR is differentially expressed on various primary lung carcinomas. In patients with SmCC, low expression correlates with worse prognosis, suggesting that GCR expression may be a useful predictor of survival in patients with SmCC. Further studies are needed analyzing survival data following GC treatment and chemotherapy to determine the combined effect on patient outcome.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 226, Tuesday Afternoon