评估 Amphiregulin、磷酸酶和张力蛋白同系物（PTEN）和 P21 表达在转移性结直肠癌抗 EGFR 治疗中的价值。

Evaluating the value of Amphiregulin, Phosphatase and Tensin Homologue (PTEN) and P21 Expression for Anti-EGFR Treatment in Metastatic Colorectal Carcinoma.

机构信息

Department of Clinical Oncology & Nuclear Medicine, Faculty of Medicine, Zagazig University, Egypt.

Department of Medical Oncology, Faculty of Medicine, Zagazig University, Egypt.

出版信息

Asian Pac J Cancer Prev. 2021 Apr 1;22(4):1025-1034. doi: 10.31557/APJCP.2021.22.4.1025.

BACKGROUND

Despite the significant progress in target therapy for the treatment of metastatic colorectal carcinoma (mCRC), the overall survival isn't satisfactory.

METHODS

We assessed the expression of Amphiregulin, PTEN, and P21 in sections from 23 paraffin blocks prepared from 23 patients with left-sided mCRC using immunohistochemistry (IHC). The relationship between their level of expressions, clinicopathological parameters, response to anti-EGFR, and prognosis were analyzed.

RESULTS

High Amphiregulin, PTEN and low P21 expression levels were associated with low tumor grade (p= 0.038 and 0.025 respectively), better response to anti-EGFR treatment (p <0.001), and favorable outcome {progression-free survival (PFS) and overall survival (OS)} (p <0.05). There was a direct relation between Amphiregulin and PTEN expressions (phi coefficient=+0.840), while there was an inverse relation between P21expression and both Amphiregulin (phi coefficient= -0.840) and PTEN expressions (phi coefficient = -1.000), which was statistically significant (P <0.001).

CONCLUSION

High Amphiregulin and PTEN expression levels and low P21 expression levels were associated with better response to anti-EGFR therapy and improved survival outcome. They might be considered predictive markers of response to anti-EGFR therapy in mCRC.

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背景

尽管转移性结直肠癌（mCRC）的靶向治疗取得了重大进展，但总体生存率仍不理想。

方法

我们使用免疫组织化学（IHC）检测了 23 例左侧 mCRC 患者的 23 个石蜡块中的 Amphiregulin、PTEN 和 P21 的表达情况。分析了它们的表达水平与临床病理参数、抗 EGFR 反应和预后的关系。

结果

高 Amphiregulin、PTEN 和低 P21 表达水平与肿瘤分级较低有关（p=0.038 和 0.025），对抗 EGFR 治疗的反应更好（p<0.001），并且预后良好{无进展生存期（PFS）和总生存期（OS）}（p<0.05）。Amphiregulin 与 PTEN 表达之间存在直接关系（phi 系数=+0.840），而 P21 表达与 Amphiregulin（phi 系数=-0.840）和 PTEN 表达之间存在负相关（phi 系数=-1.000），且具有统计学意义（p<0.001）。