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EGFR expression stratifies oligodendroglioma behavior.

Craig Horbinski1, Jonathan Hobbs, Kathleen Cieply

  • 1Department of Pathology, University of Kentucky, Lexington, KY 40536, USA. craig.horbinski@uky.edu

The American Journal of Pathology
|August 16, 2011
PubMed
Summary
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Epidermal growth factor receptor (EGFR) immunohistochemistry (IHC) shows varying prognostic value in gliomas. EGFR IHC can aid in diagnosing oligodendroglial tumors and identifying cases for further genetic testing.

Area of Science:

  • Neuro-oncology
  • Molecular diagnostics
  • Cancer biology

Background:

  • Epidermal growth factor receptor (EGFR) signaling is crucial for glioma development and a therapeutic target.
  • The diagnostic utility of EGFR expression in routine neuropathology for gliomas remains unclear.

Purpose of the Study:

  • To investigate the role of EGFR expression, assessed by immunohistochemistry (IHC), in the diagnosis and prognosis of infiltrative gliomas.
  • To correlate EGFR expression with tumor grade, histological subtype, and patient survival.

Main Methods:

  • Prospective analysis of EGFR IHC in 750 adult infiltrative gliomas.
  • Correlation of EGFR expression with World Health Organization (WHO) grade, astrocytic vs. oligodendroglial subtypes, and 1p/19q codeletion status.
  • Assessment of EGFR amplification using fluorescence in situ hybridization (FISH) in relation to EGFR expression levels.

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Main Results:

  • EGFR expression increased with WHO tumor grade.
  • EGFR expression did not significantly differ between grade-matched astrocytic and oligodendroglial tumors.
  • In grade II oligodendrogliomas with 1p/19q codeletion, strong EGFR expression correlated with reduced survival, while in grade III anaplastic oligodendrogliomas, strong EGFR expression was associated with favorable survival.
  • EGFR amplification likelihood increased with EGFR expression strength, with weak/no expression cases rarely showing amplification.

Conclusions:

  • EGFR IHC provides valuable prognostic information for oligodendroglial tumors, particularly when combined with 1p/19q codeletion status.
  • EGFR IHC can serve as a cost-effective screening tool to identify gliomas unlikely to harbor EGFR amplification, potentially reducing the need for FISH analysis.
  • EGFR IHC has a defined role in supplementing neuropathological diagnostics for specific glioma subtypes.