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Diffuse EGFR staining is associated with reduced overall survival in locally advanced oesophageal squamous cell
L Gibault1, J-P Metges, V Conan-Charlet
1Department of Anatomical Pathology, Hepato-Gastroenterology, La Cavale Blanche Hospital, Boulevard Tanguy Prigent, 29609 Brest Cedex, France.
Abstract:
Squamous cell carcinoma of the oesophagus (SCCO) is still a pathology of bad prognosis. Specific therapies are now developed against epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2, c-kit receptor (CD117), vascular endothelial growth factor (VEGF) and p53 protein. This study was aimed at assessing their expression in a large series of SCCO, as well as their potential therapeutic interest in this pathology. Immunohistochemical expression of these factors was assessed retrospectively in 107 cases of SCCO with primary surgery, as well as their relationships to recurrence, metastasis and overall survival on a long-term follow-up. Human epidermal growth factor receptor 2 and CD117 were expressed in less than 3% of the cases. Epidermal growth factor receptor and p53 were overexpressed in 68.2 and 66.4% of the cases, and VEGF in 38.3%. Epidermal growth factor receptor overexpression was significantly related to vascular invasion (P=0.023). Its diffuse positivity was significantly related in multivariate analysis to higher local recurrence (P=0.006) and lower overall survival (P=0.003), in a subgroup of patients of poor outcome who had received postoperative adjuvant treatment. These results highlight the great potential prognostic and therapeutic interest of evaluating EGFR diffuse positivity in locally advanced SCCO.
Insights
Squamous cell carcinoma of the oesophagus (SCCO) has a poor prognosis. Epidermal growth factor receptor (EGFR) diffuse positivity is linked to higher recurrence and lower survival in advanced SCCO, suggesting therapeutic potential.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Squamous cell carcinoma of the oesophagus (SCCO) remains a disease with a poor prognosis.
- Targeted therapies against specific receptors like epidermal growth factor receptor (EGFR) are emerging.
- Understanding the expression of these targets is crucial for treatment development.
Purpose of the Study:
- To assess the expression of EGFR, human epidermal growth factor receptor 2, c-kit receptor (CD117), vascular endothelial growth factor (VEGF), and p53 in SCCO.
- To evaluate the potential therapeutic interest of these factors in SCCO.
- To correlate their expression with clinical outcomes such as recurrence, metastasis, and survival.
Main Methods:
- Retrospective immunohistochemical analysis of 107 SCCO cases treated with primary surgery.
- Long-term follow-up to assess relationships between biomarker expression and clinical outcomes.
- Multivariate analysis to identify independent prognostic factors.
Main Results:
- EGFR and p53 were overexpressed in 68.2% and 66.4% of cases, respectively. VEGF was expressed in 38.3%.
- Human epidermal growth factor receptor 2 and CD117 expression was found in less than 3% of cases.
- EGFR overexpression correlated with vascular invasion. Diffuse EGFR positivity was significantly associated with higher local recurrence and lower overall survival in a subgroup of patients with poor outcomes receiving adjuvant treatment.
Conclusions:
- EGFR and p53 are frequently overexpressed in SCCO.
- Diffuse EGFR positivity demonstrates significant prognostic value, indicating higher recurrence and reduced survival.
- Evaluating EGFR expression holds considerable prognostic and therapeutic potential for locally advanced SCCO, especially in patients receiving adjuvant therapy.
