EGFR expression in urothelial carcinoma of the upper urinary tract is associated with disease progression and metaplastic morphology
EGFR expression in urothelial carcinoma of the upper urinary tract is associated with disease progression and metaplastic morphology
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DOI：
10.1111/j.1600-0463.2008.00859.x
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发表时间：
2008-01-01
期刊：
影响因子：
2.8
通讯作者：
Langner, Cord
中科院分区：
文献类型：
--
作者：
Leibl, Sebastian;Zigeuner, Richard;Langner, Cord
EGFR 代表了尿路上皮癌 (UC) 的一个有前途的治疗靶点。我们的研究旨在探讨 EGFR 在上尿路 UC 中的临床病理意义。使用组织微阵列技术对 268 个连续肿瘤进行免疫组织化学评估（EGFR pharmDX 试剂盒 (TM)），并将其与其他组织病理学参数以及患者结果相关联。在 140/253 (55%) 例可评估 UC 中观察到 EGFR 免疫反应性，并且与高肿瘤分期（47% pTa/pT1 vs 66% pT2-pT4；p=0.003）和高肿瘤分级（45% 低级别 vs 67% 高级别；p < 0.001）相关。此外，EGFR 表达与化生鳞状细胞和/或腺体分化相关（p < 0.001）。 49% 的病例 EGFR 染色强度为 1+，31% 的病例为 2+，20% 的病例为 3+。通过单变量分析，EGFR 3+ 染色强度与转移性疾病的发生相关（p=0.016）。然而，多变量分析证明，只有 pT 分期 > 1 (p < 0.001) 和高肿瘤分级 (p < 0.001) 是患者结果的独立预测因素。总之，EGFR 与晚期疾病和化生鳞状和/或腺体分化显着相关。由于具有化生形态的 UC 已被证明对传统放疗或化疗更具抵抗力，这些肿瘤中惊人的强 EGFR 表达可能为受影响的患者提供新的视角。
EGFR represents a promising therapeutic target in urothelial cancer (UC). Our study aimed to investigate the clinicopathological significance of EGFR in upper urinary tract UC. EGFR was immunohistochemically assessed (EGFR pharmDX kit (TM)) in 268 consecutive tumours using a tissue microarray technique and correlated with other histopathological parameters as well as patient outcome. EGFR immunoreactivity was observed in 140/253 (55%) evaluable UCs and was associated with high tumour stage (47% pTa/pT1 vs 66% pT2-pT4; p=0.003) and high tumour grade (45% low grade vs 67% high grade; p < 0.001). In addition, EGFR expression was associated with metaplastic squamous and/or glandular differentiation (p < 0.001). EGFR staining intensity was 1+ in 49%, 2+ in 31%, and 3+ in 20% of cases. EGFR 3+ staining intensity was associated with the occurrence of metastatic disease by univariate analysis (p=0.016). Multivariate analysis, however, proved only pT stage > 1 (p < 0.001) and high tumour grade (p < 0.001) to be independent predictors of patient outcome. In conclusion, EGFR was significantly associated with advanced disease and metaplastic squamous and/or glandular differentiation. Since UCs with metaplastic morphology have been shown to be more resistant to conventional radiotherapy or chemotherapy, the strikingly strong EGFR expression in these tumours may offer a new perspective for affected patients.