Nicholson R I, Gee J M, Harper M E
Tenovus Cancer Research Centre, Welsh School of Pharmacy, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff CF10 3XF, UK.
Eur J Cancer. 2001 Sep;37 Suppl 4:S9-15. doi: 10.1016/s0959-8049(01)00231-3.
Elevated levels of the epidermal growth factor receptor (EGFR), a growth-factor-receptor tyrosine kinase, and/or its cognate ligands have been identified as a common component of multiple cancer types and appear to promote solid tumour growth. This article examines the relationship between EGFR expression and cancer prognosis based on literature compiled on PubMed between 1985 and September 2000. More than 200 studies were identified that analysed relapse-free-interval or survival data directly in relation to EGFR levels in over 20000 patients. Analysis of the data showed that 10 cancer types both express elevated levels of EGFR relative to normal tissues and have been studied in sufficient depth to allow sound judgements to be made concerning the association between EGFR and patient outlook. The EGFR was found to act as a strong prognostic indicator in head and neck, ovarian, cervical, bladder and oesophageal cancers. In these cancers, increased EGFR expression was associated with reduced recurrence-free or overall survival rates in 70% (52/74) of studies. In gastric, breast, endometrial and colorectal cancers, the EGFR provided more modest prognostic information, correlating to poor survival rates in 52% (13/25) of studies, while in non-small cell lung cancer (NSCLC), EGFR expression only rarely (3/10 studies) related to patient outlook. However, it is likely that the true prognostic significance of the EGFR has been underestimated as the published studies only assessed total cellular EGFR levels, rather than the activated form of the receptor, and were not standardised with regard to patient populations or assay methods. Finally, it is important to stress that failure to detect a prognostic significance for EGFR in any one cancer type does not necessarily preclude patients from benefiting from anti-EGFR therapies.
表皮生长因子受体（EGFR）是一种生长因子受体酪氨酸激酶，其水平升高和/或其同源配体已被确定为多种癌症类型的共同特征，似乎能促进实体瘤生长。本文基于1985年至2000年9月在PubMed上收集的文献，研究了EGFR表达与癌症预后之间的关系。共识别出200多项研究，这些研究直接分析了20000多名患者的无复发生存期或生存数据与EGFR水平的关系。数据分析表明，有10种癌症类型相对于正常组织均表达升高水平的EGFR，并且已进行了足够深入的研究，以便就EGFR与患者预后之间的关联做出可靠判断。发现EGFR在头颈癌、卵巢癌、宫颈癌、膀胱癌和食管癌中是一个强有力的预后指标。在这些癌症中，70%（52/74）的研究表明EGFR表达增加与无复发生存率或总生存率降低相关。在胃癌、乳腺癌、子宫内膜癌和结直肠癌中，EGFR提供的预后信息较为有限，52%（13/25）的研究表明其与生存率低相关，而在非小细胞肺癌（NSCLC）中，EGFR表达仅很少（3/10项研究）与患者预后相关。然而，EGFR的真正预后意义可能被低估了，因为已发表的研究仅评估了细胞总EGFR水平，而非受体的活化形式，并且在患者群体或检测方法方面未进行标准化。最后，必须强调的是，在任何一种癌症类型中未能检测到EGFR的预后意义并不一定排除患者从抗EGFR治疗中获益。
