Expression And Their Clinical Significance Of ERα, ERβ And VEGF In Non-small Cell Lung Cancer

Background:Non-small cell lung cancer (NSCLC) accounts for approximately 80% of lung cancer which is the leading cause of cancer death throughout the world now. Because of the difficulty in early diagnosis, most patients were at advanced stage or had metastases and were inoperable when diagnosed. Even if they had done lobectomy or pneumonectomy, they are finally dead for locoregional recurrence or distant metastases. And the 5-year-survival rate of NSCLC is very low.Researches indicated that estrogen receptor (ER) not only consist in the estrogen targeted apparatus such as breast and uterus but also consist in the non-estrogen targeted apparatus such as encephaloma, colonic cancer, liver cancer, lung cancer etc. It has also been found that the expression of estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ) in the tissue of NSCLC are correlated with their prognosis. Vascular endothelial growth factor (VEGF) is belong to transmembrane receptor. It plays an important role on endodermis cells of blood vessel. VEGF is a key regulator in neovascularization, especially involved in tumor growth and metastasis. We used immunohistochemistry to investigate the expression of ERα, ERβand VEGF in 53 NSCLC cases. We explored the relationships between their expression and the significance in the diagnosis and treatment of NSCLC and the impact on the prognosis.Objective:To investigate the expression of estrogen receptor subtypes (ERαand ERβ) and VEGF in non-small cell lung cancer, explore their relationships, clinical parameters and prognosis.Methods:Immunohistochemical staining was used to detect ERα, ERβand VEGF exprossion in 53 cases of NSCLC and 26 tumor-adjacent normal lung tissues. Compare exprossion of ERα, ERβand VEGF with the clinicopathological characteristics. Evaluate the correlation between these factors and prognosis.Results:1. In the 26 tumor-adjacent normal lung tissues, ERαprotein expressed in 8 cases and its positive rate was 30.8%; ERβprotein expressed in 11 cases and its positive rate was 42.3%; VEGF protein expressed in 18 cases and its positive rate was 69.2%. While in the 53 cases of NSCLC tissues, ERαprotein expressed in 42 cases, accounting for 79.2%; ERβprotein expressed in 36 cases, accounting for 67.9%, VEGF protein expressed in 42 cases, accounting for 79.2%. The difference in expression of ERαand the expression of ERβis statistically significant in tumor and tumor-adjacent normal lung tissues (P＜0.05). VEGF expression in cancer tissues is no significant statistically compared with that in tumor-adjacent normal lung tissues(P＞0.05).2. The expression of ERα, ERβand VEGF protein had no significant correlation with patient age, sex, TNM stage, smoking or not, tumor type, differentiation, tumor size and lymph node metastasis respectively.3. The survival rates were 19.05% in patients which has a positive expression of ERα, while 18.18% in the negatives. The median survival span was 28.91 months for the positive expression patients as 27.91 months for the negatives. The survival curves between patients which had a positive or negative expression of ERαprotein have nonsignificant differences (P＜0.05). Log-rank test x2= 0.01, P= 0.9384. There was no significant difference. The survival rates were 22.22% in patients positive of ERβ, while 11.76% in the negatives. The median survival span was 27.91 months for the positive expression patients as 29.57 months for the negatives. The survival curves between patients which had a positive or negative expression of ERβprotein have nonsignificant differences (P＜0.05). Log-rank test x2=0.29, P= 0.5934. There was no significant difference. The survival rates were 19.05% in patients positive of VEGF, while 11.76% in the negatives. The median survival span was 27.22 months for the positive expression patients as 28.91 months for the negatives. The survival curves between patients which had a positive or negative expression of VEGF protein have nonsignificant differences (P＜0.05). Log-rank test x2=0.12, P=0.7296. There was no significant difference.4. There was a negative correlation between the expression of ERαand VEGF in NSCLC tissues(r=0.197, P=0.157). There was a positive correlation between the expression of ERβand VEGF (r=0.272, P=0.049). There was a negative correlation between the expression of ERαand ERβ(r=-0.033,P=0.817)。Conclusion:ERαand ERβexpression in NSCLC tissues was significantly higher than in normal lung tissues. There was no significant difference between VEGF expression in NSCLC tissues or in normal lung tissues. ERα, ERβand VEGF expression does not correlate with the prognosis of NSCLC. The expression of ERαhad no significant correlation with the expression of VEGF or ERβin NSCLC tissues, while there was a positive correlation between the expression of ERβand VEGF.