Immunohistochemical Expression of EGFR Oncoprotein and Its Prognostic Significance in Salivary Gland Carcinomas

Czech version

Authors: I. Stárek ¹; L. Kučerová ²; A. Skálová ³; M. Brož ¹; T. Bakaj ¹; A. Zapletalová ⁴; L. Hostička ⁵
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN, Olomouc ; přednosta prof. MUDr. I. Stárek, CSc. Ústav patologie, FN Olomouc ¹; přednosta doc. MUDr. M. Tichý, CSc. Ústav patologie, FN Plzeň ²; přednosta prof. MUDr. M. Michal Ústav lékařské biofyziky LF UP, Olomouc ³; přednostka doc. RNDr. H. Kolářová, CSc. Stomatologická klinika FN Plzeň ⁴; přednosta doc. MUDr. A. Zicha, CSc. ⁵
Published in: Otorinolaryngol Foniatr, 60, 2011, No. 2, pp. 78-84.
Category: Original Article

Overview

Background:
To investigate the expression of EGFR oncoprotein in salivary gland carcinomas and to correlate it with the prognosis, T stage of the primary and its cervical metastases.

Methods:
Immunohistochemistry for EGFR protein was performed in 76 carcinomas, using formalin-fixed paraffin-embedded sections. For the evaluation of reactivity of tumor cells, a histoscore combining membranous staining intensity (scala no reaction, weak, moderate, strong) with the percentage of positive cells, namely 0 (no reaction or reaction in <10 % cells), 1+, 2+, 3+ (weak, moderate, strong in ≥ 10 % of cells) was applied. Prognostic correlation was performed in a subset of 55 patients in three different modes: I. 0 negative vs. 1+, 2+, and 3+ positive. II. 0, 1+ negative vs. 2+ and 3+ positive. III. 0, 1+, 2+ negative vs. 3+ positive. Univariate disease-specific survival curves were calculated by Kaplan-Meier method, the distributions were compared with the log-rank test. For the same modes, correlation between EGFR expression and the T stage of the primary and its cervical metastases was evaluated using Fisher’s exact test.

Results:
39.5 % (30/76) carcinomas were EGFR negative, 60,5 % (46/76) were positive, with the histoscore of the latter making 1+, 2+ and 3+ in 15 (32.6 %) (1+), 12 (26.1 %) and 19 (41.3 %) cases, respectively. In adenoid cystic, salivary duct and mucoepidermoid carcinoma and carcinoma ex pleomorphic adenoma the EGFR immunoreaction tested positive in 65.5 % (19/29), 47.8 % (11/23), 83.3 % (5/6) and 100 % (4/4) of cases, respectively. 80 % (4/5) of acinic cell carcinomas were scored with 0. Of other histopathologic entities, positive EGFR immunoreaction was recorded in undifferentiated carcinoma (2/2), malignant mixed tumour (1/2), adenocarcinoma NOS (1/1), papillary-cystic adenocarcinoma (1/1) and mammary analogue secretory carcinoma of salivary glands (1/1). One each small cell carcinoma and cribriform cystadenocarcinoma was EGFR negative. The disease-specific survival in EGFR positive carcinomas differed from that in EGFR negative ones, especially in modus II, but no statistic significance was recorded (p=0.073).

Conclusions:
Of all histopathological entities tested, carcinoma ex pleomorphic adenoma, undifferentiated carcinoma and adenocarcinoma NOS showed 100% immunoreactivity, the reaction of other histotypes was less frequent with a variable histoscore. We failed to demonstrate any statistical significance of EGFR expression for the prognosis, T stage and cervical metastases of salivary gland carcinomas.

Key words:
EGFR oncoprotein, salivary gland carcinoma, prognosis.

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