Akheel Mohammad, Wadhwania Ashmi, Venkataramu Vinay, Qazi Mukhallat, Vijay Tanvi, Sidheeq Meharunneesa Aboobacker
College of Dentistry, City University Ajman, Ajman, UAE.
Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, India.
J Maxillofac Oral Surg. 2024 Aug;23(4):873-880. doi: 10.1007/s12663-024-02263-9. Epub 2024 Jul 1.
Squamous cell carcinomas are the most common type of oral cancer contributing for around 90%. The overall survival is below 50% for these patients. There is a requirement for a non-invasive marker to predict the prognosis. The epidermal growth factor (EGF) and their receptors (EGFR, ErbB-1) are not only documented to play a critical and an influential role in cell growth and differentiation in normal/healthy tissues, but may also plays an important role in malignant disease progression and tumorigenesis.
This study was done to find the significance of EGF receptor expression on microscopic free tumour margins and lymph nodal margins to predict the survival of the patient in a 2-year follow-up.
A prospective cohort study of 25 patients was performed in biopsy proven oral squamous cell carcinoma patients who reported to our department from July 2017 to June 2019. The data were collected from their histopathological report, they were- pTNM staging, surgical margins (superior and inferior, anterior, posterior), nodal status and scoring of EGFR expression on wax blocks was done. Total of 125 wax blocks were analysed for the study. Follow-up of 2 years were recorded in the study to evaluate the survival of the patients.
The expression of EGFR on microscopic tumour-free surgical margins and lymph nodes was value 0.023 which was statistically significant. The level of significance between EGFR and status of patients after 2-year follow-up was having value 0.031. Out of 25 patients, 5 patients were dead at a 2-year follow-up. Out of these 5 patients who were dead, 3 patients had a local recurrence and 2 patients had distant metastasis.
This cohort study concludes that EGFR is an important prognostic marker and must be analysed in all microscopic tumour-free margins and lymph nodes in advanced oral squamous cell carcinomas to predict the local recurrences affecting the survival of the patients and the need for addition of anti-EGFR agents in adjuvant treatment. Since the sample size is small, large scale studied must be done to validate the need for adding anti-EGFR agents in adjuvant treatment to improve the survival of patients.
鳞状细胞癌是口腔癌最常见的类型，约占90%。这些患者的总体生存率低于50%。需要一种非侵入性标志物来预测预后。表皮生长因子（EGF）及其受体（EGFR，ErbB-1）不仅被证明在正常/健康组织的细胞生长和分化中起关键和有影响的作用，而且在恶性疾病进展和肿瘤发生中也可能起重要作用。
本研究旨在探讨表皮生长因子受体（EGF receptor）在显微镜下肿瘤切缘和淋巴结切缘的表达对患者2年随访生存率的预测意义。
对2017年7月至2019年6月到我院就诊的25例经活检证实的口腔鳞状细胞癌患者进行前瞻性队列研究。从他们的组织病理学报告中收集数据，包括pTNM分期、手术切缘（上下、前后）、淋巴结状态，并对蜡块上的EGFR表达进行评分。共分析125个蜡块用于本研究。在研究中记录2年的随访情况以评估患者的生存率。
EGFR在显微镜下无肿瘤手术切缘和淋巴结上的表达值为0.023，具有统计学意义。EGFR与2年随访后患者状态之间的显著性水平值为0.031。25例患者中，2年随访时有5例死亡。在这5例死亡患者中，3例有局部复发，2例有远处转移。
本队列研究得出结论，EGFR是一个重要的预后标志物，在晚期口腔鳞状细胞癌中，必须对所有显微镜下无肿瘤切缘和淋巴结进行分析，以预测影响患者生存的局部复发情况以及辅助治疗中添加抗EGFR药物的必要性。由于样本量较小, 必须进行大规模研究以验证在辅助治疗中添加抗EGFR药物以提高患者生存率的必要性。
