Galizia Gennaro, Lieto Eva, Ferraraccio Francesca, De Vita Ferdinando, Castellano Paolo, Orditura Michele, Imperatore Vincenzo, La Mura Anna, La Manna Giovanni, Pinto Margherita, Catalano Giuseppe, Pignatelli Carlo, Ciardiello Fortunato
Division of Surgical Oncology, F. Magrassi and A. Lanzara Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, Naples, 80131, Italy.
Ann Surg Oncol. 2006 Jun;13(6):823-35. doi: 10.1245/ASO.2006.05.052. Epub 2006 Apr 18.
To investigate the role of epidermal growth factor receptor (EGFR) expression as a prognostic marker for prediction of cancer behavior and clinical outcomes in colon cancer patients undergoing potentially curative surgery.
EGFR determination using a commercially available immunohistochemistry kit was performed in tissues from 149 colon cancer patients receiving primary surgical treatment and in 25 normal colon mucosa specimens from noncancer patients. EGFR positivity was correlated in univariate and multivariate analyses with disease recurrence and survival. In addition, p27, p53, and vascular endothelial growth factor expression were assessed by immunohistochemistry in 104 patients and correlated with EGFR tumor expression and clinical outcome.
EGFR expression was detected in approximately one third of colon cancer patients (53 of 149; 35.6%). In 126 curatively treated patients, EGFR expression was correlated with disease recurrence and worse survival in both univariate and multivariate analyses. In a multivariate model for predicting recurrence and survival, Dukes' staging, p27, and EGFR expression were the only independent covariates. In particular, in Dukes' A and B patients the 5-year survival probability was 96% for EGFR-negative and high p27 expression cases and was 30.7% for EGFR-positive and low p27 expression cases.
EGFR expression was an independent prognostic indicator of disease recurrence and poor survival in colon cancer patients undergoing curative surgery. In the context of novel therapeutic options such as molecularly targeted therapies, these findings suggest that anti-EGFR drugs could be evaluated in the adjuvant treatment of EGFR-positive colon cancer patients.
探讨表皮生长因子受体（EGFR）表达作为接受潜在根治性手术的结肠癌患者癌症行为及临床预后预测的预后标志物的作用。
使用市售免疫组织化学试剂盒对149例接受初次手术治疗的结肠癌患者的组织以及25例非癌患者的正常结肠黏膜标本进行EGFR检测。在单因素和多因素分析中，将EGFR阳性与疾病复发和生存情况进行关联。此外，通过免疫组织化学对104例患者评估p27、p53和血管内皮生长因子表达，并与EGFR肿瘤表达及临床结局进行关联。
约三分之一的结肠癌患者（149例中的53例；35.6%）检测到EGFR表达。在126例接受根治性治疗的患者中，单因素和多因素分析均显示EGFR表达与疾病复发及较差的生存率相关。在预测复发和生存的多因素模型中，Dukes分期、p27和EGFR表达是仅有的独立协变量。特别是在Dukes A期和B期患者中，EGFR阴性且p27高表达病例的5年生存概率为96%，而EGFR阳性且p27低表达病例的5年生存概率为30.7%。
EGFR表达是接受根治性手术的结肠癌患者疾病复发和生存不良的独立预后指标。在诸如分子靶向治疗等新型治疗选择的背景下，这些发现提示可在EGFR阳性结肠癌患者的辅助治疗中评估抗EGFR药物。
