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- Title
Prognostic value of localization of epidermal growth factor receptor in lung adenocarcinoma.
- Authors
Wang, Jinn-Li; Fang, Chia-Lang; Tzeng, Yu-Tien; Hsu, Han-Lin; Lin, Sey-En; Yu, Ming-Chih; Bai, Kuan-Jen; Wang, Liang-Shun; Liu, Hsingjin Eugene
- Abstract
Background: The nuclear translocation of epidermal growth factor receptor (EGFR) has been considered to play a role in carcinogenesis. However, the relevance of differentially located EGFR proteins in lung cancer remains unclear. Methods: We examined 161 patients with primary lung adenocarcinoma to detect EGFR expression in lung cancer cells using immunohistochemistry and determined the correlations of EGFR expression with clinical characteristics, EGFR mutations, and survival time. Moreover, we graded complete membranous staining with strong intensity as high membranous EGFR (<bold>m</bold>EGFR) expression, and nuclear EGFR staining with strong intensity as high nuclear (<bold>n</bold>EGFR) expression. Results: The prevalence of high <bold>m</bold>EGFR and <bold>n</bold>EGFR expression in lung adenocarcinoma was 42.86 and 39.13%, respectively. After multivariate analyses, high <bold>m</bold>EGFR expression was associated with a significantly reduced mortality risk in older patients, those with a history of smoking, and those without brain metastasis (hazard ratio[95% confidential interval], HR[95% CI] = 0.55[0.32~ 0.92]; 0.51[0.26~ 0.98] and 0.56[0.33~ 0.94], in overall survival, respectively). An association between high <bold>n</bold>EGFR expression and early recurrence was observed in patients with metastasis (HR[95% CI] =1.68[1.05~ 2.68], in progression-free survival). Notably, patients with low <bold>m</bold>EGFR and low <bold>n</bold>EGFR expression had the lowest survival rate in cases without brain metastasis (<italic>p</italic> = 0.018) and with a history of smoking (<italic>p</italic> = 0.062) and total EGFR (any high <bold>m</bold>EGFR or <bold>n</bold>EGFR) expression indicated a more favorable response to platinum-based chemotherapy regardless of EGFR mutations (HR[95% CI] =0.33[0.12–0.92]; adjusted HR[95% CI] = 0.36[0.13~ 1.02] with the use of tyrosine kinase inhibitor). Conclusions: EGFR proteins at different cellular locations in lung adenocarcinoma might influence the biology of cancer cells and are an independent indicator of more favorable prognosis and treatment response.
- Subjects
EPIDERMAL growth factor receptors; ADENOCARCINOMA; CARCINOGENESIS; BRAIN metastasis; LUNG cancer; PROTEIN-tyrosine kinase inhibitors; GEFITINIB
- Publication
Journal of Biomedical Science, 2018, Vol 25, Issue 1, pN.PAG
- ISSN
1021-7770
- Publication type
Article
- DOI
10.1186/s12929-018-0451-3