Serum levels of epidermal growth factor and HER-2 neu in non small-cell lung cancer: prognostic correlation

Lung cancer is still a leading cause of cancer related mortality all over the world with the majority of cases are discovered at a late stage. Various panels of molecular prognostic markers are being studied to map the association of these markers with response and survival. The aim of this study is to study levels of epidermal growth factor receptor (EGFR), HER-2 neu in both serum and bronchoalveolar lavage (BAL) in patients with non small-cell lung cancer (NSCLC), correlate their levels with clinical, pathological characters as well as prognosis. A total of 30 patients with pathologically proven NSCLC were enrolled in this study in addition to ten normal controls subjects and ten cases with benign pulmonary diseases as broncheicatsis, chronic obstructive pulmonary disease. Results revealed significantly increased levels of EGFR and HER-2 neu in both serum and bronco-alveolar lavage compared with controls. The levels were significantly higher in those with stages III, IV compared with I, II, and in those with higher grades of the tumor. There was no statistically significant correlation with performance status or survival. In conclusion, serum measurement of these markers is a promising noninvasive technique which needs correlation with other methods of determination, measurement at different chronological points during disease evolution to explore its full potential. Standardization of techniques for determination of EGFR and HER-2 neu over-expression must become a priority in future studies that should also include larger number of patients, conducted in a prospective manner together with comparisons of various methods and correlation of protein expression with gene copy numbers.