Perini Marcos Vinicius, Montagnini Andre Luis, Coudry Renata, Patzina Rosely, Penteado Sonia, Abdo Emilio Elias, Diniz Alessandro, Jukemura Jose, da Cunha Jose Eduardo Monteiro
Department of Gastroenterology, Surgical Division, University of Sao Paulo Medical School, Sao Paulo, Brazil.
ANZ J Surg. 2015 Mar;85(3):174-8. doi: 10.1111/ans.12399. Epub 2013 Sep 25.
Identification of molecular markers in pancreatic adenocarcinoma (PA) has the potential to guide targeted therapy. The objective of this study is to determine the prognostic significance of epidermal growth factor receptor (EGFR) expression (membrane and cytoplasmic) in resected PA and its correlation with lymph node metastasis and survival.
EGFR overexpression was determined by immunohistochemistry, and the pattern of expression was compared between the primary tumour, adjacent normal pancreas and involved lymph nodes.
A total of 88 patients had curative resection. No difference was found in mEGFR overexpression between tumoural and metastatic nodal tissues (P = 0.28). Median overall survival time was 22.9 months. Overall cumulative 1-, 3- and 5-year survival was 48%, 20% and 18%, respectively. In positive mEGFR tumour expression, survival was 46% at 1 year, 8% at 3 years and 0% at 5 years (P < 0.05). Univariate analysis showed that male gender, portal vein (PV) resection, perineural, lymphovascular and peri-pancreatic invasion, positive margins and positive mEGFR expression in tumour tissue had worse survival. Multivariate analysis showed that male gender, PV resection, vascular and perineural invasion remained independent predictors of poor survival.
Positive mEGFR overexpression is associated with decreased survival; however, it is not an independent prognostic factor.
鉴定胰腺腺癌（PA）中的分子标志物具有指导靶向治疗的潜力。本研究的目的是确定表皮生长因子受体（EGFR）表达（膜性和胞质性）在接受手术切除的PA中的预后意义及其与淋巴结转移和生存的相关性。
通过免疫组织化学确定EGFR过表达，并比较原发肿瘤、邻近正常胰腺和受累淋巴结之间的表达模式。
共有88例患者接受了根治性切除。肿瘤组织和转移淋巴结组织之间的mEGFR过表达无差异（P = 0.28）。中位总生存时间为22.9个月。1年、3年和5年的总累积生存率分别为48%、20%和18%。在mEGFR肿瘤表达阳性的患者中，1年生存率为46%，3年生存率为8%，5年生存率为0%（P < 0.05）。单因素分析显示，男性、门静脉（PV）切除、神经周围、淋巴管和胰腺周围侵犯、切缘阳性以及肿瘤组织中mEGFR表达阳性的患者生存率较差。多因素分析显示，男性、PV切除、血管和神经周围侵犯仍然是生存不良的独立预测因素。
mEGFR过表达阳性与生存率降低相关；然而，它不是一个独立的预后因素。
