Department of Pathology, School of Medicine, University of Rijeka, Rijeka, Croatia.
Mod Pathol. 2010 Mar;23(3):392-403. doi: 10.1038/modpathol.2009.166. Epub 2010 Jan 8.
The epidermal growth factor receptor (EGFR)-family and cyclin-D1 have been extensively studied in breast cancer; however systematic studies that examine protein expression and gene status in the same cohort of patients are lacking. Also emerging evidences suggest existence of a direct EGFR-signaling pathway, which involves cellular transport of EGFR from cell membrane to the nucleus, and transcriptional regulation of the target genes. Thus, we examined the protein expression of membrane EGFR, nuclear EGFR, cyclin-D1 and the corresponding gene status in 113 breast carcinomas by immunohistochemistry and fluorescence in situ hybridization using tissue microarrays. Membrane EGFR overexpression and EGFR gene amplification were detected in 2% cases, while nuclear EGFR was detected in 40% of cases, with 12% having high nuclear EGFR staining. Nuclear EGFR correlated with tumor size (P=0.0005), lymph node metastasis (P=0.0288), Nottingham prognostic index (P=0.0011) and estrogen receptor (ER) expression (P=0.0258) but the letter correlation was observed only in premenopausal group of patients. Strong cyclin-D1 expression and cyclin-D1 gene (CCND1) amplification were found in 64 and 13% of the cases, respectively. Cyclin-D1 expression showed positive correlation with ER (P=0.0113) and inverse correlation with Nottingham prognostic index (P=0.0309) and membrane EGFR (P=0.0201). CCND1 amplification also showed inverse correlation with membrane EGFR (P=0.0420). A strong correlation between membrane EGFR expression and gene amplification (P=0.0035), as well as cyclin-D1 overexpression and gene amplification (P=0.0362), was demonstrated. On univariate analysis cyclin-D1 expression showed a correlation with longer overall survival in the premenopausal group and nuclear EGFR correlated with shorter overall survival in whole cohort as well in the premenopausal group of patients. Multivariate analysis revealed nuclear EGFR to be an independent prognostic factor and showed 3.4 times greater mortality risk for nuclear EGFR+++ patients as compared with nuclear EGFR negative patients (hazard ratio =3.402; P=0.0026).
表皮生长因子受体(EGFR)家族和细胞周期蛋白 D1 已在乳腺癌中得到广泛研究;然而,缺乏在同一批患者中同时检查蛋白质表达和基因状态的系统研究。此外,新出现的证据表明存在直接的 EGFR 信号通路,该通路涉及 EGFR 从细胞膜到细胞核的细胞内运输,以及靶基因的转录调节。因此,我们使用组织微阵列通过免疫组织化学和荧光原位杂交检查了 113 例乳腺癌中的膜 EGFR、核 EGFR、细胞周期蛋白 D1 和相应基因状态的蛋白表达。膜 EGFR 过表达和 EGFR 基因扩增在 2%的病例中检测到,而核 EGFR 在 40%的病例中检测到,其中 12%具有高核 EGFR 染色。核 EGFR 与肿瘤大小(P=0.0005)、淋巴结转移(P=0.0288)、诺丁汉预后指数(P=0.0011)和雌激素受体(ER)表达(P=0.0258)相关,但仅在绝经前组患者中观察到这种相关性。在 64%和 13%的病例中分别发现了强细胞周期蛋白 D1 表达和细胞周期蛋白 D1 基因(CCND1)扩增。细胞周期蛋白 D1 表达与 ER 呈正相关(P=0.0113),与诺丁汉预后指数(P=0.0309)和膜 EGFR(P=0.0201)呈负相关。CCND1 扩增也与膜 EGFR 呈负相关(P=0.0420)。强膜 EGFR 表达与基因扩增之间存在很强的相关性(P=0.0035),以及细胞周期蛋白 D1 过表达与基因扩增之间存在相关性(P=0.0362)。在单变量分析中,细胞周期蛋白 D1 表达与绝经前组的总生存时间较长相关,核 EGFR 与整个队列以及绝经前组的总生存时间较短相关。多变量分析显示核 EGFR 是一个独立的预后因素,核 EGFR+++患者的死亡率是核 EGFR 阴性患者的 3.4 倍(危险比=3.402;P=0.0026)。