Specificities of Lung Adenocarcinoma in Women Who Have Never Smoked
Specificities of Lung Adenocarcinoma in Women Who Have Never Smoked
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DOI：
10.1097/jto.0b013e3182904dfb
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发表时间：
2013-07-01
影响因子：
20.4
通讯作者：
Fouret, Pierre
中科院分区：
文献类型：
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作者：
Mazieres, Julien;Rouquette, Isabelle;Fouret, Pierre
引言：没有明确的数据表明女性非烟草依赖型肺癌发病率高。我们假设遗传事件或激素因素可能部分参与其中。方法：我们的目的是比较吸烟和不吸烟两组女性肺癌的临床、病理和生物学特征。共有140名患有腺癌的女性（63名从不吸烟的女性和77名曾经或现在吸烟的女性）被纳入这项研究。结果：与吸烟者相比，不吸烟者具有更高的年龄（67岁比58.7岁，p < 0.0001）和更高的黄疸特征频率（60.3%比37.7%,p = 0.008）。我们根据吸烟状况观察到女性基因改变重分配的差异：50.8%的不吸烟者表现出表皮生长因子受体（EGFR）突变，而吸烟者为10.4% （p < 0.001）。相比之下，吸烟者（33.8%）比不吸烟者（9.5%,p = 0.001）更频繁地发生K-Ras突变。我们还观察到，与吸烟者相比，从不吸烟的患者雌激素受体（ER）表达的百分比更高（p = 0.03；两种不同抗体的p = 0.008）。雌激素受体和孕激素受体在两组间无显著差异。最后，ER表达与EGFR突变的存在相关。结论：本研究表明，当肺癌发生在从不吸烟的女性时，其更频繁地与EGFR突变和ER表达相关，两者之间存在相关性。这些发现强调了通过针对激素因素和基因异常来治疗从未吸烟的女性的可能性。
Introduction: No clear data are available on the high rate of tobacco-independent lung cancer in women. We hypothesize that genetic events or hormonal factors may be partly involved.Methods: We aimed to compare clinical, pathological, and biological characteristics of lung cancer in two cohorts of women: smokers and never-smokers. A total of 140 women (63 never-smokers and 77 former/current smokers) with adenocarcinoma, were included in this study.Results: The never-smokers were characterized by a higher age (67 versus 58.7 years; p < 0.0001) and a higher frequency of lepidic features (60.3% versus 37.7%; p = 0.008) compared with smokers. We observed differential genetic alteration repartition in women according to their tobacco status: 50.8% of never-smokers displayed an epidermal growth factor receptor (EGFR) mutation versus 10.4% of smokers (p < 0.001). In contrast, K-Ras was more frequently mutated in smokers (33.8%) than in never-smokers (9.5%; p = 0.001). We also observed a higher percentage of estrogen receptors (ER) expression (p = 0.03; and p = 0.008 with two different antibodies) in patients who never smoked when compared with smokers. There was no significant difference in ER and progesterone receptors between the groups. Finally, ER expression was correlated with the presence of an EGFR mutation.Conclusions: This study suggests that when lung cancer occurs in women who have never smoked, it is more frequently associated with an EGFR mutation and ER expression, with a correlation between both markers. These findings underline the possibility of treating women who have never smoked by targeting both hormonal factors and genetic abnormalities.