Pinton Giulia, Manzotti Beatrice, Balzano Cecilia, Moro Laura
Department of Pharmaceutical Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
J Thorac Dis. 2021 Mar;13(3):1851-1863. doi: 10.21037/jtd-20-2277.
Thoracic malignancies represent a significant global health burden with incidence and mortality increasing year by year. Thoracic cancer prognosis and treatment options depend on several factors, including the type and size of the tumor, its location, and the overall health status of patients. Gender represents an important prognostic variable in thoracic malignancies. One of the greatest biological differences between women and men is the presence of female sex hormones, and an increasing number of studies suggest that estrogens may play either a causative or a protective role in thoracic malignancies. Over the past 60 years since the discovery of the first nuclear estrogen receptor (ER) isoform α and the almost 20 years since the discovery of the second estrogen receptor, ERβ, different mechanisms governing estrogen action have been identified and characterized. This literature review reports the published data regarding the expression and function of ERs in different thoracic malignancies and discuss sex disparity in clinical outcomes. From this analysis emerges that further efforts are warranted to better elucidate the role of sex hormones in thoracic malignancies, and to reduce disparities in care between genders. Understanding the mechanisms by which gender-related differences can affect and interfere with the onset and evolution of thoracic malignancies and impact on response to therapies could help to improve the knowledge needed to develop increasingly personalized and targeted treatments.
胸部恶性肿瘤是一项重大的全球健康负担，其发病率和死亡率逐年上升。胸癌的预后和治疗选择取决于多个因素，包括肿瘤的类型和大小、其位置以及患者的整体健康状况。性别是胸部恶性肿瘤的一个重要预后变量。女性和男性之间最大的生物学差异之一是女性性激素的存在，并且越来越多的研究表明雌激素可能在胸部恶性肿瘤中发挥致病或保护作用。自发现首个核雌激素受体（ER）亚型α以来的60年里，以及自发现第二个雌激素受体ERβ以来的近20年里，已经确定并描述了调控雌激素作用的不同机制。这篇文献综述报告了关于ERs在不同胸部恶性肿瘤中的表达和功能的已发表数据，并讨论了临床结果中的性别差异。从这一分析中可以看出，有必要进一步努力，以更好地阐明性激素在胸部恶性肿瘤中的作用，并减少性别之间的治疗差异。了解性别相关差异影响和干扰胸部恶性肿瘤的发生和发展以及对治疗反应的机制，有助于提高开发日益个性化和靶向治疗所需的知识。
