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Considering all the smoking-related side effects, greater efforts should be made in order to better support patients in smoking cessation. Smoking should be considered as a real physical disorder and similar surveys should be encouraged with the aim to fight the 'stigma' of smoking that still exists among patients.

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Lung cancer in women has some different characteristics than men, with more adenocarcinoma (ADC), higher risk in never Rationalesmokers, differences in DNA repair machinery and more frequent EGFR mutations in women. Epidemiologic evidence supporting a role for reproductive and hormonal status in lung cancer has been somewhat inconsistent, mainly in retrospective and surgical cohorts of patients, and the mechanism modulating the expression and function of hormonal receptors in lung cancer still remain unclear. We aimed to assess possible correlation between sex-linked hormone receptor expression and the activation of specific growth factor signalling and DNA repair pathways.We collected a series of 66 chemotherapy-treated consecutive patients (46 men, 20 women), referred to Methodsthe Thoracic Oncology Unit of San Luigi Hospital during 2008, with advanced stage of lung cancer including 27 ADC, 19 squamous cell carcinoma and 11 small cell carcinoma. The remaining nine cases were diagnosed as "NSCLC-NOS" (non small cell lung carcinoma -not otherwise specified). The immunodetection of estrogen receptors (ERa and ERβ), progesterone receptor (PR), EGFR and ERCC1 was scored assessing both staining intensity and extension; aromatase reactivity was scored as 0 (totally negative) or 1 (presence of cytoplasmic staining).ERβ was generally expressed at high levels, while ERa and PR had a weak, preferentially in women, or null expression. Results-According to median expression levels, no significant correlation was found among clinico-pathological features and ERβ and aromatase expression, respectively. EGFR expression was different among histotypes (p=0.003) and ERCC1 expression correlated with stage of disease (p=0.03). Aromatase was found in 27% of cases, generally associated to a worse outcome (p=0.04), especially in men (p=0.004). With regard to the male population, the combination ERCC1 low/Aromatase negative showed better outcome compared to ERCC1 high/Aromatase positive patients (p=0.001) and ERCC1 low/ERβ low patients resulted in survival improvement compared to ERCC1 high/ERβ high (p=0.03), ERCC1 high/ERβ low (p=0.03) and ERCC1 low/ERβ high (p=0.01) respectively. In NSCLC subgroup, a significant different outcome was found between ERCC1 low/ERβ low and ERCC1 low/ERβ high (p=0.03).The small number of currently Conclusionsinvestigated lung cancer patients showed a differential behaviour of the hormonal setting, considering histotype and sex features. The above markers will be assessed in a supplementary case series of advanced lung tumors, in order to better define the clinical meaning of these factors in a widen population and further understand some peculiarities of lung cancer, focusing on gender differences. This abstract is funded by: none Am J Respir Crit Care Med 183;2011:A5091 Internet address: www.atsjournals.org Online Abstracts Issue