Cell membrane and cytoplasmic epidermal growth factor receptor expression in pancreatic ductal adenocarcinoma

The significance of over-expression of epidermal growth factor receptor (EGFR) in pancreatic carcinoma is unclear. In this study, we examined the association between EGFR over-expression (membranous and cytoplasmic), the associated histopathologic features and clinical outcomes in post-resection pancreatic cancer patients. EGFR expression was determined immunohistochemically in 90 patients who underwent resection for pancreatic cancer. Cytoplasmic expression was considered positive if EGFR expression was seen in the cytoplasm in ≥ 10% of cells. Cell membrane staining was scored from 0 to 3+, with 2+ and 3+ being considered as membrane over-expression. Overall survival and progression-free survival were calculated using the Kaplan-Meier method, and survival curves were compared by the log-rank test. Out of 90 patients, 51 (57%) and 74 (68%) patients had membrane and cytoplasmic EGFR over-expression, respectively. There was a statistically significant correlation between cell membrane EGFR over-expression and lymph node positivity (P = 0.03). Patients with membrane EGFR over-expression had a shorter median progression-free survival (10.7 vs. 17.0 months, P = 0.02) and overall survival (15.9 months vs. 25.3 months, P = 0.17). Cytoplasmic EFGR over-expression was not significantly associated with recurrence or survival. Membrane EGFR over-expression in resected pancreatic cancer patients was associated with worse clinical outcomes than non-over-expression.