Abstract

Sex hormones have been linked to cancer, although their relationship remains undefined. This study aimed to compare the serum blood levels of estradiol and testosterone among patients with lung cancer, those convalescing with benign pulmonary lesions, and healthy individuals. An electronic search was conducted for relevant studies that were published up to May 2019 and provided the mean and standard deviation of the serum blood levels of sex hormones. A random–effect model was utilized to achieve significant heterogeneity from the published data. Nineteen studies involving 961 patients with lung cancer, 262patients with benign pulmonary lesion, and 676 healthy individuals were analyzed. The meta–analysis showed that estradiol serum blood levels were higher in patients with lung cancer than in those with pulmonary lesion (standard mean difference [SMD]=4.58, 95% confidence interval [CI] [–0.61, 9.77], P=0.08) and healthy individuals (SMD=5.65, 95% CI [1.21, 10.08], P=0.01). By contrast, the testosterone serum blood levels were lower in patients with lung cancer than in those with pulmonary lesion (SMD=–0.97, 95% CI [–1.60, –0.33], P< 0.01) and healthy individuals (SMD=–1.05, 95%CI [–1.50, –0.59], P<0.01). Subgroup analysis showed that the above–mentioned observations were more pronounced in men than in women (P for interaction <0.05). In Chinese population, higher estradiol serum blood levels but lower testosterone serum blood levels were found in patients with lung cancer compared with those of patients with benign lung lesion and healthy individuals. Our findings provided epidemiological support for the role of sex hormones in the pathogenesis of lung cancer. The generalizability of these findings to other populations must be further studied.

Keywords

estradiol, testosterone, lung cancer, meta–analysis, chinese population