Prognostic significance and frequency of EGFR expression and amplification in surgically resected advanced gastric cancer

Jpn J Clin Oncol. 2016 Jun;46(6):507-16. doi: 10.1093/jjco/hyw030. Epub 2016 Mar 23.

Abstract

Objective: The aim of this study is to find the frequency and the role of epidermal growth factor receptor expression as a prognostic biomarker in gastric cancer.

Methods: We evaluated the prognostic value and frequency of epidermal growth factor receptor expression and amplification using immunohistochemistry and silver in situ hybridization in a large cohort of curatively resected gastric cancer.

Results: Of the total of 935 cases, 294 (31.4%), 101 (10.8%) and 36 (3.9%) patients showed epidermal growth factor receptor 1+, 2+ and 3+ expression on immunohistochemistry, respectively. Epidermal growth factor receptor-positive (2+/3+) patients more frequently had intestinal type than epidermal growth factor receptor-negative (0/1+) patients (82.5 vs. 44.1%, P < 0.001). After adjusting for sex, age, stage and adjuvant chemotherapy, epidermal growth factor receptor-positive patients had a favorable overall survival outcome compared with epidermal growth factor receptor-negative patients (hazard ratio, 0.734; 95% confidence interval, 0.541-0.997; P = 0.047), especially in Stage III disease (hazard ratio, 0.676; 95% confidence interval, 0.472-0.968; P = 0.033). Among the 393 cases available for in situ hybridization, the correlation between immunohistochemistry and in situ hybridization was statistically significant (P = 0.001). Thirteen patients with gene amplification (3.3%) did not show different survival outcome with others (P = 0.359).

Conclusion: Epidermal growth factor receptor positivity was an independent favorable prognostic factor for gastric cancer, especially in Stage III disease.

Keywords: biological markers; receptor, epidermal growth factor; rognosis; stomach neoplasms.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Disease-Free Survival
  • Doxorubicin / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Fluorouracil / therapeutic use
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism*
  • Retrospective Studies
  • Silver / chemistry
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology
  • Survival Rate

Substances

  • Biomarkers, Tumor
  • Silver
  • Doxorubicin
  • Receptor, ErbB-2
  • Cisplatin
  • Fluorouracil