Ivan Doina, Prieto Victor G, Esmaeli Bita, Wistuba Ignacio I, Tang Ximing, Lazar Alexander J F
Department of Pathology, University of Texas M D Anderson Cancer Center, Houston, TX 77030-4009, USA.
J Cutan Pathol. 2010 Feb;37(2):231-6. doi: 10.1111/j.1600-0560.2009.01316.x. Epub 2009 Jul 15.
Sebaceous carcinoma has a predominant periocular origin but can also be extraocular. These two groups have distinct clinical courses. Insight into the molecular determinants of tumorigenesis and metastasis is limited. There is no effective treatment for metastatic sebaceous carcinoma. Epidermal growth factor receptor (EGFR) is implicated in tumorigenesis and can be a therapeutic target in certain settings. We evaluated EGFR levels by immunohistochemistry (IHC), comparing its expression between periocular and extraocular tumors and assessed EGFR mutation status. IHC was performed in 36 cases: 19 periocular and 17 extraocular (10 associated with Muir-Torre syndrome-MTS). EGFR IHC was scored for percentage of positive cells (< 5%, 5-25%, 26-50%, > 50%) and intensity (+1 = low , +2 = moderate , +3 = high ). Extraocular carcinomas showed markedly increased levels of EGFR when compared to periocular carcinoma cases, both in terms of distribution (88% were > 25% of tumor cells vs. 16%) and intensity (77% were 2+ or 3+ vs. 21%) (p < 0.001). Among extraocular cases, there was significantly lower EGFR expression in MTS-related cases (p < 0.05). No EGFR mutations were identified. Our results underscore the divergent mechanisms underlying the tumorigenesis of periocular and extraocular sebaceous carcinoma and suggest an association between aggressive behavior and increased EGFR expression in extraocular sebaceous carcinoma.
皮脂腺癌主要起源于眼周，但也可发生于眼外。这两组病例具有不同的临床病程。对肿瘤发生和转移的分子决定因素的了解有限。转移性皮脂腺癌尚无有效的治疗方法。表皮生长因子受体（EGFR）与肿瘤发生有关，在某些情况下可作为治疗靶点。我们通过免疫组织化学（IHC）评估EGFR水平，比较其在眼周和眼外肿瘤中的表达，并评估EGFR突变状态。对36例病例进行了IHC检测：19例眼周肿瘤和17例眼外肿瘤（10例与穆尔-托雷综合征-MTS相关）。EGFR IHC根据阳性细胞百分比（<5%、5-25%、26-50%、>50%）和强度（+1=低、+2=中度、+3=高）进行评分。与眼周癌病例相比，眼外癌的EGFR水平在分布（88%的肿瘤细胞>25%，而眼周癌为16%）和强度（77%为2+或3+，而眼周癌为21%）方面均显著升高（p<0.001）。在眼外病例中，MTS相关病例的EGFR表达明显较低（p<0.05）。未发现EGFR突变。我们的结果强调了眼周和眼外皮脂腺癌肿瘤发生的不同机制，并提示眼外皮脂腺癌的侵袭性与EGFR表达增加之间存在关联。
