Glucocorticoid receptor expression in advanced non-small cell lung cancer: clinicopathological correlation and in vitro effect of glucocorticoid on cell growth and chemosensitivity.

The current study aimed to immunohistochemically examine the tumor glucocorticoids receptor (GR) expression in patients with advanced non-small cell lung cancer (NSCLC) and to examine the effect of glucocorticoids (GCs) on the in vitro NSCLC cells growth and chemosensitivity. High GR expression was detected in 51% of the tumor specimens. The difference in tumor GR expression was not associated with cell type, gender, age, or stage. The outcome was significantly superior for patients whose tumor showed high GR expression compared to those with either low expression or non-expression. The median progression-free survival was 8.0 versus 5.6 months (p=0.039) and overall survival was 18.1 versus 10.2 months, (p=0.003), respectively. Almost all these patients have received GC as antiemetics or allergic preventive treatment during chemotherapy courses, therefore, the effect of GC on the chemosensitivity in vivo was not evaluable. However, in vitro cytotoxicity assay showed that dexamethasone (DEX) had heterogeneous effects on the growth and chemosensitivity of the NSCLC cell lines. These findings suggest that tumor samples express high levels of GR in about half of the patients with advanced NSCLC, and this high expression of GR may be associated with better outcome. The effect of GC treatment on the chemosensitivity in NSCLC patients remains to be established.