Kozłowska-Geller Monika, Głuszek Stanisław, Lewitowicz Piotr
Department of Physiology, Institute of Medical Science, Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Department of Surgery and Surgical Nursing, Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Prz Gastroenterol. 2021;16(4):330-338. doi: 10.5114/pg.2021.104980. Epub 2021 Mar 31.
Both environmental and genetic factors increase the likelihood of developing rectal cancer.
To assess the EGFR and p21 immunoreactivity in rectal cancer and to assess its relationship with the clinical outcome.
Applying exclusion criteria, 102 patients with stage I-IV rectal cancer, who had undergone scheduled surgery during the period 2005-2011, were included in the study. There was a follow-up study with a span of 5 years from the date of the surgery. Immunohistochemistry using epidermal growth factor receptor (EGFR Ab10, Clone111.6) and antibodies against p21 (p21 (Clone H252)) was performed to detect overexpression of the targeted receptor. Digital analysis of positive reactions of membranes and nuclei was performed utilizing Visiopharm.
The degree of EGFR intensity (log OR = 0.854, OR = 2.35, 95% CI: 1.14-4.85, = 0.021) is a significant factor in the prognosis of death within 2 years after surgery. The OS curve showed a significant decrease after 40 months from the date of surgery in the cases where EGFR had high expression. The ROC curve for cancer stage, according to the UICC classification and EGFR expression, in order to predict 2-year RFS, reached a high specificity value (ROC = 0.81, = 0.0408). The analysis showed no statistically significant differences in the survival curves of patients in groups with immunoreactivity of p21 protein at 0, 1, 2, 3 ( = 0.6453 in the log-rank test). Also, it is not a significant risk factor for death (HR = 0.915, = 0.7842) or for tumor dissemination (HR = 0.94, = 0.9426).
The determination of EGFR immunoreactivity is important in the monitoring and treatment of patients with rectal cancer, as opposed to p21.
环境因素和遗传因素均会增加患直肠癌的可能性。
评估直肠癌中表皮生长因子受体（EGFR）和p21的免疫反应性，并评估其与临床结局的关系。
应用排除标准，纳入2005年至2011年期间接受择期手术的102例I-IV期直肠癌患者。自手术日期起进行为期5年的随访研究。采用表皮生长因子受体（EGFR Ab10，克隆号111.6）和抗p21抗体（p21（克隆号H252））进行免疫组织化学检测，以检测靶向受体的过表达。利用Visiopharm对细胞膜和细胞核的阳性反应进行数字分析。
EGFR强度程度（对数OR = 0.854，OR = 2.35，95%置信区间：1.14 - 4.85，P = 0.021）是术后2年内死亡预后的重要因素。EGFR高表达的病例，自手术日期起40个月后总生存（OS）曲线显著下降。根据国际抗癌联盟（UICC）分类和EGFR表达绘制的预测2年无复发生存（RFS）的癌症分期ROC曲线，达到了较高的特异性值（ROC = 0.81，P = 0.0408）。分析显示，p21蛋白免疫反应性为0、1、2、3级的患者组生存曲线无统计学显著差异（对数秩检验中P = 0.6453）。此外，它不是死亡（风险比（HR）= 0.915，P = 0.7842）或肿瘤播散（HR = 0.94，P = 0.9426）的显著危险因素。
与p21相反，EGFR免疫反应性的测定在直肠癌患者的监测和治疗中具有重要意义。
