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Epidermal growth factor receptor expression correlates with poor survival in gastric adenocarcinoma from Mexican patients: a multivariate analysis using a standardized immunohistochemical detection system.

Abstract
The aim of the study was to determine epidermal growth factor receptor (EGFR) expression in gastric adenocarcinoma by standardized immunohistochemistry and to correlate EGFR expression with clinical features and patient survival. EGFR expression was investigated in paraffin sections of resection specimens of 89 gastric carcinomas from Mexican Mestizo patients using standardized immunohistochemistry with antigen retrieval (Dako EGFRpharmDx assay detection system). Membrane staining of EGFR was evaluated in the neoplastic cells and graded using a semiquantitative score (0-3+). Of the 89 carcinomas examined, staining of neoplastic cells was weak in 17 (19.1%, score 1+), moderate in 16 (18.0%, score 2+), and strong in nine cases (10.1%, score 3+). EGFR reactivity was heterogeneous, frequently showing completely negative up to 3+ positive areas within an individual tumor. EGFR reactivity score correlated with distant metastases (P=0.002) and clinical stage (P=0.033). EGFR score 0/1+ was significantly associated with an increase in patient survival when compared to score 2+/3+ (P=0.0006). In a multivariate analysis, EGFR positive cells in muscularis or subserosa (P=0.004), distant metastases (P=0.016) and residual disease (P=0.039) were significantly correlated with decreased survival. The prognosis was associated with the EGFR reactivity score (P=0.003), distant metastases (P=0.0001) and residual disease (P=0.012) in a univariate analysis. EGFR reactivity in neoplastic cells is an independent prognostic factor in gastric adenocarcinoma. The relevance of the heterogeneity in EGFR expression with regard to tumor progression, metastasis and anti-EGFR therapy needs to be studied.
AuthorsArmando Gamboa-Dominguez, Claudia Dominguez-Fonseca, Leticia Quintanilla-Martinez, Edgardo Reyes-Gutierrez, Dan Green, Arturo Angeles-Angeles, Raymonde Busch, Christine Hermannstädter, Jörg Nährig, Karl-Friedrich Becker, Ingrid Becker, Heinz Höfler, Falko Fend, Birgit Luber
JournalModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc (Mod Pathol) Vol. 17 Issue 5 Pg. 579-87 (May 2004) ISSN: 0893-3952 [Print] United States
PMID15073595 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • ErbB Receptors
Topics
  • Adenocarcinoma (metabolism, pathology)
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • ErbB Receptors (biosynthesis)
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Mexico
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Proportional Hazards Models
  • Stomach Neoplasms (metabolism, pathology)
  • Survival Analysis

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