Department of Pathology, University of Kentucky, Lexington, KY 40536, USA.
Am J Pathol. 2011 Oct;179(4):1638-44. doi: 10.1016/j.ajpath.2011.06.020. Epub 2011 Aug 11.
Epidermal growth factor receptor (EGFR) expression and signaling contribute to glioma biological features and, thus, are a target for new drug development. The role, if any, of EGFR in routine surgical neuropathological diagnostics is less clear. Herein, we describe prospective EGFR IHC analysis in an adult cohort comprising 750 infiltrative gliomas. EGFR expression increased with World Health Organization grade but did not significantly differ between grade-matched astrocytic and oligodendroglial tumors. Survival did not significantly differ by EGFR expression among astrocytic tumors adjusted for World Health Organization grade. However, grade II oligodendrogliomas with strong EGFR expression and 1p/19q codeletion showed reduced survival, compared with their codeleted counterparts with weaker EGFR expression. Surprisingly, an inverse phenomenon was found with grade III anaplastic oligodendrogliomas, in which stronger EGFR expression was a favorable marker for survival. Among all gliomas, the likelihood of EGFR amplification, as viewed by fluorescence in situ hybridization, increased with the strength of EGFR expression, and <1% of cases with weak or no EGFR immunostaining showed amplification. These data suggest that EGFR IHC is useful in certain circumstances (ie, it may help supplement 1p/19q prognostic information in oligodendroglial tumors and screen out cases that would not benefit from more costly EGFR fluorescence in situ hybridization analysis).
表皮生长因子受体 (EGFR) 的表达和信号转导有助于神经胶质瘤的生物学特征，因此是新药开发的目标。EGFR 在常规手术病理诊断中的作用尚不清楚。在此，我们描述了一项前瞻性的 EGFR IHC 分析，纳入了 750 例浸润性神经胶质瘤的成人队列。EGFR 的表达随着世界卫生组织 (WHO) 分级的增加而增加，但在匹配的星形细胞瘤和少突胶质细胞瘤之间没有显著差异。在调整了 WHO 分级的星形细胞瘤中，EGFR 表达与生存之间没有显著差异。然而，与 EGFR 表达较弱的 1p/19q 共缺失的肿瘤相比，强 EGFR 表达的 II 级少突胶质细胞瘤的生存时间较短。令人惊讶的是，III 级间变性少突胶质细胞瘤出现了相反的现象，其中强 EGFR 表达是生存的有利标志物。在所有神经胶质瘤中，荧光原位杂交观察到的 EGFR 扩增的可能性随着 EGFR 表达的增强而增加，并且在免疫组化显示 EGFR 弱表达或无表达的病例中，扩增的比例<1%。这些数据表明，EGFR IHC 在某些情况下是有用的（即，它可能有助于补充少突胶质细胞瘤 1p/19q 预后信息，并筛选出不会从更昂贵的 EGFR 荧光原位杂交分析中获益的病例）。
