Seshadri R, McLeay W R, Horsfall D J, McCaul K
Department of Haematology, Flinders University School of Medicine, Adelaide, South Australia.
Int J Cancer. 1996 Feb 20;69(1):23-7. doi: 10.1002/(SICI)1097-0215(19960220)69:1<23::AID-IJC5>3.0.CO;2-Y.
Bearing in mind the continuing controversy over the prognostic significance of epidermal growth factor receptor (EGF-r) expression, we investigated its clinical significance prospectively in 345 primary breast cancer patients. The prognostic significance of EGF-r expression, as measured by a radioligand binding assay, was determined by Cox's multivariate analysis using EGF-r concentration as a continuous or dichotomous variable. Increased EGF-r expression was detected in 20-32% of tumours, depending on the cut-off in concentration used. EGF-r expression, irrespective of the cut-off, was not associated with tumour size or grade or the number of axillary nodes involved. There was, however, a strong inverse association between EGF-r expression and the absence of hormone receptors. After a median follow-up period of 57 months, multivariate analysis suggested that EGF-r expression was associated with increases in risk for both relapse and death from breast cancer, even after adjusting for oestrogen receptor (ER) concentration, tumour size and the number of axillary nodes involved. Patients with ER-positive tumours, which also expressed EGF-r, had increases in risk for both relapse and death from breast cancer compared with tumours without EGF-r. Expression of EGF-r was not a predictor of poor prognosis in either node-negative or ER-negative subgroups of patients.
鉴于表皮生长因子受体（EGF-r）表达的预后意义仍存在争议，我们对345例原发性乳腺癌患者进行了前瞻性研究，以探讨其临床意义。通过放射性配体结合试验测定的EGF-r表达的预后意义，采用Cox多变量分析，将EGF-r浓度作为连续或二分变量进行测定。根据所使用的浓度临界值，在20%-32%的肿瘤中检测到EGF-r表达增加。无论临界值如何，EGF-r表达均与肿瘤大小、分级或腋窝淋巴结受累数目无关。然而，EGF-r表达与激素受体缺失之间存在强烈的负相关。在中位随访期57个月后，多变量分析表明，即使在调整了雌激素受体（ER）浓度、肿瘤大小和腋窝淋巴结受累数目后，EGF-r表达仍与乳腺癌复发和死亡风险增加相关。与无EGF-r的肿瘤相比，ER阳性且表达EGF-r的肿瘤患者乳腺癌复发和死亡风险均增加。在淋巴结阴性或ER阴性亚组患者中，EGF-r表达均不是预后不良的预测指标。
