Demir Lutfiye, Yigit Seyran, Sadullahoglu Canan, Akyol Murat, Cokmert Suna, Kucukzeybek Yuksel, Alacacioglu Ahmet, Cakalagaoglu Fulya, Tarhan Mustafa Oktay
Department of Medical Oncology, Ataturk State Hospital, Aydin, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(22):9739-45. doi: 10.7314/apjcp.2014.15.22.9739.
We aimed to evaluate the effects of hormone receptor, HER2, and epidermal growth factor receptor (EGFR) expression on epithelial ovarian cancer (EOC) prognosis and investigate whether or not phenotypic subtypes might exist.
The medical records of 82 patients who were diagnosed with EOC between 2003 and 2012 and treated by platinum-based chemotherapy were retrospectively evaluated. Expression of EGFR, oestrogen (ER), progesterone (PR), and cerbB2 (HER2) receptors were assessed immunohistochemically on paraffin-embedded tissues of these patients. Three phenotypic subtypes were defined according to ER, PR, and HER2 expression and associations of these with EGFR expression, clinicopathologic features, platinum sensitivity, and survival were investigated.
When we classified EOC patients into three subtypes, 63.4% had hormone receptor positive (HR(+)) (considering breast cancer subtypes, luminal A), 18.3% had triple negative, and 18.3% had HER2(+) disease. EGFR positivity was observed in 37 patients (45.1%) and was significantly more frequent with advanced disease (p=0.013). However, no significant association with other clinicopathologic features and platinum sensitivity was observed. HER2(+) patients had significantly poorer outcomes than HER2(-) counterparts (triple negative and HR positive patients) (p=0.019). Multivariate analysis demonstrated that the strongest risk factor for death was residual disease after primary surgery.
Triple negative EOC may not be an aggressive phenotype as in breast cancer. The HER2 positive EOC has more aggressive behaviour compared to triple negative and HR(+) phenotypes. EGFR expression is more frequent in advanced tumours, but is not related with poorer outcome. Additional ovarian cancer molecular subtyping using gene expression analysis may provide more reliable data.
我们旨在评估激素受体、HER2和表皮生长因子受体（EGFR）表达对上皮性卵巢癌（EOC）预后的影响，并研究是否存在表型亚型。
回顾性评估2003年至2012年间诊断为EOC并接受铂类化疗的82例患者的病历。在这些患者的石蜡包埋组织上通过免疫组织化学评估EGFR、雌激素（ER）、孕激素（PR）和cerbB2（HER2）受体的表达。根据ER、PR和HER2表达定义了三种表型亚型，并研究了它们与EGFR表达、临床病理特征、铂敏感性和生存率的相关性。
当我们将EOC患者分为三种亚型时，63.4%为激素受体阳性（HR(+)）（参照乳腺癌亚型，即管腔A型），18.3%为三阴性，18.3%为HER2(+)疾病。37例患者（45.1%）观察到EGFR阳性，且在晚期疾病中明显更常见（p = 0.013）。然而，未观察到与其他临床病理特征和铂敏感性有显著相关性。HER2(+)患者的预后明显比HER2(-)患者（三阴性和HR阳性患者）差（p = 0.019）。多变量分析表明，原发性手术后残留疾病是死亡的最强危险因素。
三阴性EOC可能不像乳腺癌那样具有侵袭性表型。与三阴性和HR(+)表型相比，HER2阳性EOC具有更具侵袭性的行为。EGFR表达在晚期肿瘤中更常见，但与较差的预后无关。使用基因表达分析进行额外的卵巢癌分子分型可能会提供更可靠的数据。
