Epidermal growth factor receptor expression correlates with poor survival in gastric adenocarcinoma from Mexican patients:: a multivariate analysis using a standardized immunlohistochemical detection system
Epidermal growth factor receptor expression correlates with poor survival in gastric adenocarcinoma from Mexican patients:: a multivariate analysis using a standardized immunlohistochemical detection system
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DOI：
10.1038/modpathol.3800085
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发表时间：
2004-05-01
期刊：
影响因子：
7.5
通讯作者：
Luber, B
中科院分区：
文献类型：
--
作者：
Gamboa-Dominguez, A;Dominguez-Fonseca, C;Luber, B
本研究的目的是通过标准化免疫组织化学方法确定胃腺癌中表皮生长因子受体（EGFR）的表达，并将EGFR表达与临床特征和患者生存率相关联。采用标准化免疫组织化学抗原修复法（Dako EGFRpharmDX（TM）检测系统）研究了89例墨西哥梅斯蒂索患者胃癌切除标本石蜡切片中EGFR的表达。在肿瘤细胞中评价EGFR的膜染色，并使用半定量评分（0-3 +）进行分级。在检查的89例癌中，17例（19.1%，评分1 +）的肿瘤细胞染色较弱，16例（18.0%，评分2 +）为中度，9例（10.1%，评分3+）为强。EGFR反应性是异质性的，在单个肿瘤内经常显示完全阴性至3+阳性区域。EGFR反应性评分与远处转移（P=0.002）和临床分期（P=0.033）相关。与评分2 + /3 +相比，EGFR评分0/1 +与患者生存率增加显著相关（P=0.0006）。在多因素分析中，肌层或浆膜下EGFR阳性细胞（P=0.004）、远处转移（P=0.016）和残留病变（P=0.039）与生存率下降显著相关。单因素分析显示，预后与EGFR反应性评分（P=0.003）、远处转移（P=0.0001）和残留病灶（P=0.012）相关。肿瘤细胞中EGFR的反应性是胃腺癌的独立预后因素。EGFR表达的异质性与肿瘤进展、转移和抗EGFR治疗的相关性有待研究。
The aim of the study was to determine epidermal growth factor receptor (EGFR) expression in gastric adenocarcinoma by standardized immunohistochemistry and to correlate EGFR expression with clinical features and patient survival. EGFR expression was investigated in paraffin sections of resection specimens of 89 gastric carcinomas from Mexican Mestizo patients using standardized immunohistochemistry with antigen retrieval (Dako EGFRpharmDX(TM) assay detection system). Membrane staining of EGFR was evaluated in the neoplastic cells and graded using a semiquantitative score (0-3 +). Of the 89 carcinomas examined, staining of neoplastic cells was weak in 17 (19.1%, score 1 +), moderate in 16 (18.0%, score 2 +), and strong in nine cases (10.1%, score 3+). EGFR reactivity was heterogeneous, frequently showing completely negative up to 3+ positive areas within an individual tumor. EGFR reactivity score correlated with distant metastases (P=0.002) and clinical stage (P=0.033). EGFR score 0/1 + was significantly associated with an increase in patient survival when compared to score 2 + /3 + (P=0.0006). In a multivariate analysis, EGFR positive cells in muscularis or subserosa (P=0.004), distant metastases (P=0.016) and residual disease (P=0.039) were significantly correlated with decreased survival. The prognosis was associated with the EGFR reactivity score (P=0.003), distant metastases (P=0.0001) and residual disease (P=0.012) in a univariate analysis. EGFR reactivity in neoplastic cells is an independent prognostic factor in gastric adenocarcinoma. The relevance of the heterogeneity in EGFR expression with regard to tumor progression, metastasis and anti-EGFR therapy needs to be studied.