Epidermal growth factor receptor expression in 780 breast cancer patients: A reappraisal of the prognostic value based on an eight-year median follow-up
Epidermal growth factor receptor expression in 780 breast cancer patients: A reappraisal of the prognostic value based on an eight-year median follow-up
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DOI：
10.1023/a:1011183421477
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发表时间：
2001-06-01
影响因子：
50.5
通讯作者：
Milano, G
中科院分区：
文献类型：
--
作者：
Ferrero, JM;Ramaioli, A;Milano, G
目的：由于新的治疗方法以表达表皮生长因子受体(EGFR)的肿瘤为靶点，本研究的目的是对乳腺癌中EGFR的表达谱进行深入分析，并重新评估其预后价值。平均年龄61岁(25~85岁)。所有患者均接受了肿瘤切除加腋窝淋巴结清扫，其中373例(47.8%)行乳房切除术，37例(5%)行皮下乳房切除术，370例(47.2%)行肿瘤切除术。EGFR的中位数为9fmol/mg蛋白，只有一小部分患者表现出相对明显的EGFR表达。肿瘤大小、分级、结节状态和EGFR肿瘤水平之间没有联系。根据患者的年龄，EGFR肿瘤水平持续而显著地下降。雌激素受体(ER)与表皮生长因子受体(EGFR)呈显著负相关。中位随访期97个月，最短4个月，最长228个月。单因素分析发现，组织学分级、肿瘤大小、结节状态和ER状态都是影响生存率的显著因素，考虑到无转移和总体生存率。多变量分析显示，只有组织学分级、肿瘤大小和淋巴结状况仍是独立的生存预测因素。结论：EGFR测定作为乳腺癌预后指标的价值有限。
Purpose: Because new therapeutic approaches target tumors expressing epidermal growth factor receptor (EGFR), the aim was to undertake a thorough analysis of the expression profile of EGFR in breast cancer and to reassess its prognostic value.Patients and methods: Tumor EGFR levels were determined by a specific ligand binding assay in 780 consecutive breast cancer patients followed in our institute between 1980 and 1993. Mean age was 61 years (25-85 years). All patients had undergone tumor resection with axillary lymph node dissection: 373 patients (47.8%) underwent mastectomy, 37 (5%) subcutaneous mastectomy and 370 (47.2%) tumorectomy.Results: EGFR levels ranged between non-detectable up to 789 fmol/mg protein. EGFR median value was 9 fmol/mg protein and only a small proportion of patients exhibited a relatively marked EGFR expression. There was no link between tumor size, grade, node status and EGFR tumoral levels. There was a constant and significant decrease in EGFR tumoral levels according to patient age. A significant inverse relationship was found between estradiol receptors (ER) and EGFR. Median follow-up was 97 months with a minimum at 4 months and a maximum at 228 months. From univariate analysis it was found that histological grade, tumor size, node status and ER status were all significant predictors of survival, considering metastasis-free as well as overall survival. Using multivariable analysis, only histological grade, tumor size and node status remained independent predictors of survival.Conclusion: EGFR determination is of limited value as a prognostic indicator in breast cancer.