Department of Radiation Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
PLoS One. 2020 Dec 17;15(12):e0243891. doi: 10.1371/journal.pone.0243891. eCollection 2020.
Prognostic biomarker, which can inform the treatment outcome of adjuvant chemotherapy (ACT) after complete resection of early-stage non-small cell lung cancer (NSCLC), is urgently needed for the personalized treatment of these patients.
The prognostic value of gene expression of the estrogen receptor (ER) on the effect of ACT in completely resected NSCLC was investigated in the present study. Two independent datasets from Gene Expression Omnibus (GEO) with a total of 309 patients were included in this study. The prognostic value of ER gene expression on ACT's efficacy was evaluated by survival analysis and Cox hazards models.
We found a consistent and significant prognostic value of ERβ (ESR2) expression for ACT's efficacy in completely resected NSCLC in both of the two independent cohorts. After multivariate adjustment, a significant survival benefit of ACT was observed in patients with low expression of ESR2, with a hazard ratio (HR) of 0.19 (95%CI 0.05-0.82, p = 0.026) in the discovery cohort and an HR of 0.27 (95%CI 0.10-0.76, p = 0.012) in the validation group. No significant benefit of ACT in the subgroup of patients with high expression of ESR2 was observed, with an HR of 0.80 (95%CI 0.31-2.09, p = 0.644) in the discovery cohort and an HR of 1.05 (95%CI 0.48-2.29, p = 0.896) in the validation group.
A significant survival benefit from ACT was observed in patients with low ESR2 expression. No significant survival benefit was observed in patients with high ESR2 expression. Detection of ESR2 expression in NSCLC may help personalize its treatment after complete resection.
对于完全切除早期非小细胞肺癌（NSCLC）后的辅助化疗（ACT）的治疗结果，需要有预后生物标志物来为这些患者提供个体化治疗。
本研究探讨了雌激素受体（ER）基因表达对完全切除的 NSCLC 中 ACT 效果的预后价值。本研究纳入了来自基因表达综合数据库（GEO）的两个独立数据集，共 309 例患者。通过生存分析和 Cox 风险模型评估 ER 基因表达对 ACT 疗效的预后价值。
我们发现 ERβ（ESR2）表达在两个独立队列中均对 ACT 治疗完全切除的 NSCLC 的疗效具有一致且显著的预后价值。经过多变量调整后，在 ESR2 低表达的患者中观察到 ACT 有显著的生存获益，风险比（HR）为 0.19（95%CI 0.05-0.82，p=0.026）在发现队列和 HR 为 0.27（95%CI 0.10-0.76，p=0.012）在验证组。在 ESR2 高表达的患者亚组中未观察到 ACT 的显著获益，风险比为 0.80（95%CI 0.31-2.09，p=0.644）在发现队列和 HR 为 1.05（95%CI 0.48-2.29，p=0.896）在验证组。
在 ESR2 低表达的患者中观察到 ACT 有显著的生存获益。在 ESR2 高表达的患者中未观察到生存获益。在 NSCLC 中检测 ESR2 表达可能有助于其完全切除后的个体化治疗。
