Epidermal growth factor receptor expression status in lung cancer correlates with its mutation

The molecular mechanisms for frequent epidermal growth factor receptor (EGFR, a tyrosine kinase [TK]) and HER2 (the preferred coreceptor of EGFR) overexpression in lung cancer are poorly understood. Recent studies have shown the mutations of the TK domain in EGFR and HER2 to be present in lung cancer. The purpose of this study was to investigate the relationship between mutation status and expression of EGFR and HER2 in lung cancer. Immunostaining took place for EGFR and HER2, and mutational analyses for EGFR, HER2, and KRAS (a signaling protein) were conducted using 130 resected lung cancer specimens. Thirty-seven EGFR mutations (28%) and 8 HER2 mutations (6%), both of the TK domains, and 5 KRAS (4%) mutations were found, whereas 73 (56%) EGFR and 47 (36%) HER2 overexpressions were found. EGFR overexpression was seen more frequently in tumors with EGFR mutation (28/37, 76%) than in tumors without EGFR mutations (45/93, 48%; P = .0059). No correlation was found between HER2 mutation and HER2 expression. Multivariate regression revealed that EGFR mutation, adenocarcinoma histology, and HER2 expression were associated with EGFR expression, whereas female sex, EGFR mutation, and EGFR expression were associated with HER2 expression. In conclusion, EGFR and HER2 overexpression is frequent in lung cancer, and EGFR overexpression correlates with the EGFR TK domain mutations.     

The epidermal growth factor receptor in human pancreatic cancer.

The epidermal growth factor receptor (EGFR) and its ligands are thought to be important in the control of proliferation of many epithelial systems, including the exocrine pancreas. Abnormalities in expression of two of the known ligands of the EGFR, transforming growth factor alpha and epidermal growth factor, occur frequently in ductal adenocarcinoma of the human pancreas. We have examined an archival series of cases of pancreatic pathology for expression of the EGFR using the anti-EGFR antiserum 12E and found that there is almost ubiquitous overexpression of EGFR in pancreatic cancer and in chronic pancreatitis. Southern blot analysis showed no evidence of amplification or rearrangement of the EGFR gene. We conclude that an autocrine loop involving the EGFR system may be involved in the genesis of both neoplasia and reactive hyperplasia of pancreatic ductal epithelium.     

158例肺癌表皮生长因子受体检测及其意义探讨

目的；探讨表皮生长因子受体（ＥＧＦＲ）在肺癌中的表达特征及其临床病理意义。方法：应用ＡＢＣ免疫组织化学法对１５８例肺癌组织进行ＥＧＦＲ检测。结果：非小细胞肺 ＥＧＦＲ阳性率为８０．６％，而小细胞肺癌的ＥＧＦＲ均为阴性，并发现非小细胞肺癌ＥＧＦＲ表达与癌的组织学类型、分化程度、生物行为、肿块大小和临床分期均无相关性。结论：检测肺癌的ＥＧＦＲ有助于鉴别小细胞肺癌和非小细胞肺癌，并认为关于ＥＧＦＲ可能是     

表皮生长因子受体与胃癌的研究进展

胃癌的发生与发展机制十分复杂，涉及多种细胞病理改变。表皮生长因子受体(epidermal growth factor receptor，EGFR)及其参与的信号转导通路在胃癌的发生发展中起着重要的作用。近年来，发现多数肿瘤对放化疗存在的耐药性，因此在肿瘤的基因水平寻找诊断指标以及靶向治疗，已经成为近年来研究热点之一。本文综述表皮生长因子与胃癌的研究进展。     

Epidermal growth factor receptor and KRAS mutations in Brazilian lung cancer patients

OBJECTIVE:

Epidermal growth factor receptor is involved in the pathogenesis of non-small cell lung cancer and has recently emerged as an important target for molecular therapeutics. The KRAS oncogene also plays an important role in the development of lung cancer. The aim of this study was to evaluate the frequency of epidermal growth factor receptor and KRAS mutations in a population of Brazilian patients with non-small cell lung cancer.

METHODS:

A total of 207 specimens from Brazilian patients with non-small cell lung cancer were analyzed for activating epidermal growth factor receptor and KRAS somatic mutations, and their associations with clinicopathological characteristics (including age, gender, ethnicity, smoking habits, and histological subtype) were examined.

RESULTS:

We identified 63 cases (30.4%) with epidermal growth factor receptor mutations and 30 cases (14.6%) with KRAS mutations. The most frequent epidermal growth factor receptor mutation we detected was a deletion in exon 19 (60.3%, 38 patients), followed by an L858R amino acid substitution in exon 21 (27%, 17 patients). The most common types of KRAS mutations were found in codon 12. There were no significant differences in epidermal growth factor receptor or KRAS mutations by gender or primary versus metastatic lung cancer. There was a higher prevalence of KRAS mutations in the non-Asian patients. Epidermal growth factor receptor mutations were more prevalent in adenocarcinomas than in non-adenocarcinoma histological types. Being a non-smoker was significantly associated with the prevalence of epidermal growth factor receptor mutations, but the prevalence of KRAS mutations was significantly associated with smoking.

CONCLUSIONS:

This study is the first to examine the prevalence of epidermal growth factor receptor and KRAS mutations in a Brazilian population sample with non-small cell lung cancer.     

肺腺癌表皮生长因子受体基因突变与CT征象的相关性

目的 探讨肺腺癌CT征象对表皮生长因子受体（EGFR）基因突变的预测价值.方法 回顾性分析200例经手术切除的肺腺癌患者的CT资料,统计其术后病理标本的EGFR基因检测结果,分析两者之间的相关性.结果 单因素分析显示非吸烟、女性患者、CT征象中的含气支气管征及较小肿瘤直径与肺腺癌EGFR基因突变存在明显相关性,突变组与野生组的差异均有统计学意义（P＜0.05）,EGFR基因突变组肺腺癌磨玻璃密度（GGO）发生率高于野生组,但差异无统计学意义（P＞0.05）,其他临床及CT征象如年龄、分叶征、毛刺征、钙化、空洞、胸膜凹陷征均与EGFR基因突变无关,突变组与野生组的差异均无统计学意义（P＞0.05）.Logistics回归分析显示非吸烟及含气支气管征与EGFR基因突变明显相关,突变组与野生组的差异均有统计学意义（P＜0.05）,而性别及肿物大小与EGFR基因突变与否无明显相关性,突变组与野生组的差异均无统计学意义（P＞0.05）.结论 非吸烟、含气支气管征可作为肺腺癌EGFR基因突变的预测因素.     

Immunohistochemical detection of epidermal growth factor and epidermal growth factor receptor in the lingual mucosa of rats during the morphogenesis of filiform papillae

We examined the immunofluorescence labelling epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR), as well as differential interference contrast (DIC) images, during the morphogenesis of filiform papillae and the keratinization of the lingual epithelium of rats on semi-ultrathin sections of epoxy resin-embedded samples using laser-scanning microscopy. We also examined semi-ultrathin sections of epoxy resin-embedded, toluidine blue-stained samples by light microscopy to obtain details of cell histology and morphology. No immunoreactivity specific for EGF and EGFR was detected on the lingual epithelium of fetuses on days 12 and 16 after conception (E12 and E16), during which time the number of layers of cuboidal cells in the lingual epithelium increased from one to several. Immunoreactivity specific for EGF and EGFR was first detected on the lingual epithelium of fetuses at birth or on postnatal day 0 (P0). Immunoreactivity specific both for EGF and EGFR appeared in the connective tissue and the basal cells of the papillary and interpapillary cell columns. The lingual epithelium was composed of stratified squamous cells. The rudiments of filiform papillae were compactly arranged and interpapillary cell columns were very narrow. Immunoreactivity specific for EGF and EGFR was distinct on the cell membrane of basal cells of the papillary cell column and weakly positive on the cell membrane of basal cells of the interpapillary cell column on postnatal day 21 (P21). Thus, the patterns of immunoreactivity of EGF and EGFR differed as the filiform papillae developed. Filiform papillae developed gradually from P0 to P21. The width of interpapillary spaces also increased during this period. These observations indicate a possibility that EGF might affect the expression of keratins in the lingual epithelium via epithelium-mesenchymal interactions.     

干扰表皮生长因子受体磷酸化过程对乳腺癌的抑制效应

目的 探讨干扰表皮生长因子受体(EGFR)的磷酸化过程对裸鼠乳腺癌移植瘤生长的影响及其作用机制.方法 建立裸鼠乳腺癌移植瘤模型,成型后随机分为Ad5-hSulf1组、Ad5-EGFP组和对照组,干预治疗后,测量计算移植瘤生长率,采用免疫组化法检测各组裸鼠移植瘤hSulf-1、EGFR和p-EGFR阳性表达,采用Western blot法检测各组裸鼠移植瘤hSulf-1、EGFR和p-EGFR蛋白表达.结果 Ad5-hSulf1组裸鼠注射治疗后第14天、21天和28天的肿瘤生长率[(165.9±23.8)％,(172.6±25.9)％,(377.3±30.5)％]明显小于同期的对照组,差异均具有统计学意义(t=12.153,21.247,14.587;P =0.000).Ad5-hSulf1组裸鼠移植瘤p-EGFR阳性表达率(46.7％)和蛋白表达[(52.7±7.4)％]明显低于Ad5-EGFR组和对照组,差异均有统计学意义(x2=8.146,t=7.384,7.587;P =0.004、0.000、0.000).结论 使用hSulf1基因抑制乳腺癌细胞的EGFR磷酸化过程,可产生明显的肿瘤抑制效应,对寻求肿瘤基因治疗的一个很有潜力的靶点具有很好的借鉴参考意义.     

Phosphorylation status of epidermal growth factor receptor is closely associated with responsiveness to gefitinib in pulmonary adenocarcinoma

Twenty-one cases of primary lung carcinoma were analyzed for correlations between the presence of somatic mutations of the epidermal growth factor receptor (EGFR) gene and the phosphorylation status of EGFR, which was analyzed by immunohistochemistry with antibodies recognizing the phosphorylated form of EGFR. Somatic mutations were detected in 11 (52.4%) of the 21 cases. Immunohistochemistry with an antibody recognizing EGFR phosphorylated at tyrosine (pEGFR-tyr) 992 and an antibody recognizing EGFR phosphorylated at tyrosine 1173 (pEGFR-tyr1173) revealed that 12 (57.1%) and 21 (100%) of the 21 cases were positive, respectively. Interestingly, the mutation status of the EGFR gene was strongly correlated with immunoreactivity for pEGFR-tyr992 (P = .0019). pEGFR-tyr992 immunoreactivity was significantly correlated with clinical responsiveness to gefitinib (P = .0011). These findings suggest that immunohistochemical evaluation with anti-pEGFR-tyr992 antibody is useful for prediction of responsiveness to gefitinib.     

表皮生长因子受体和环氧合酶-2在宫颈癌中的表达及临床诊断意义

目的 探讨宫颈癌组织中表皮生长因子受体(epidermal growth factor receptor,EGFR)和环氧合酶2(cyclooxygenase,COX-2)蛋白的表达及其与临床病理特征的关系.方法 采用免疫组化的方法分别检测正常宫颈、宫颈癌中EGFR和COX-2蛋白的表达.结果 EGFR和COX-2蛋白的在宫颈癌组织中的阳性表达率,均显著高于正常宫颈组织.EGFR和COX-2的阳性表达均与患者的年龄及肿瘤大小无关(P＞0.05).多元生存分析显示,EGFR和COX-2是独立的预后因子,相对危险度分别为2.52(P=0.004)和1.88(P=0.039).结论 EGFR和COX-2在宫颈组织中的表达水平可能与肿瘤的发生、发展、浸润和转移密切相关,可作为宫颈癌恶性程度判断和预后的重要指标.     

荧光原位杂交检测非小细胞肺癌EGFR基因拷贝数状况分析

目的 探讨非小细胞肺癌EGFR基因拷贝数状况的临床病理学意义.方法 采用LSI EGFR/CEP 7探针试剂盒对108例非小细胞肺癌石蜡包埋组织标本进行EGFR基因状况的检测,并分析EGFR基因拷贝数与患者临床病理学之间的关系.结果 在108例非小细胞肺癌病例中,64.8%病例判读为EGFR基因低基因拷贝数即FISH阴性,其中二体性21.3%、低度三体性18.5%、高度三体性13.9%、低度多体性11.1%.35.2%病例判读为EGFR基因高基因拷贝数即FISH阳性,其中高度多体性25.9%、基因扩增9.3%.除2例扩增病例(Ratio>2.4)外,所有三体性及多体性,7号染色体与EGFR基因的拷贝数出现一致性的增加,Ratio范围在1.12～1.54之间.EGFR基因状况或EGFR-FISH(-/+)与临床病理特征均无显著相关性.结论 EGFR基因拷贝数增加在非小细胞肺癌是较常发生的事件,可能参与肺癌的发生发展.     

Relation of elastosis to biochemical and immunohistochemical steroid receptor findings,Ki-67 and epidermal growth factor receptor (EGFR) immunostaining in invasive ductal breast cancer

We studied 1073 cases of invasive ductal breast cancer, NOS for their elastic content (DEL, ductal + periductal elastosis; TEL, tumour elastosis) and compared the findings with the results of biochemical and immunohistochemical steroid hormone receptor examination. Tumours of patients up to 50 years of age and older were examined separately. In a number of tumours elastosis was also examined in relation to Ki-67 and epidermal growth factor receptor (EGFR) immunostaining. Sensitivity and specificity of DEL and TEL for predicting the receptor, Ki-67 and EGFR findings were estimated. Sensitivity of DEL and TEL for oestrogen and progesterone receptors is dependent on the degree of tumour differentiation and the degree of elastosis, increasing from DEL 1° and TEL 1° to DEL 3° and TEL 3°. It was more evident in grade 1 (G1) and G2 than in G3 carcinomas. Elastosis is a useful predictor of positive receptor findings particularly in G1 and G2 tumours with moderate and high-grade elastosis. It is a similarly useful predictor of negative receptor values in G3 carcinomas. The predictive value of DEL and TEL for the results of Ki-67 and EGFR immunostaining gradually decreases with increasing elastosis, consistent with the assumption that Ki-67 and EGFR identify the degree of tumour proliferation and invasion, while elastosis correlates with the degree of differentiation of breast cancer. Elastosis is a poor predictor of Ki-67 and EGFR findings in any individual breast cancer. Moderate and high-grade elastosis points to positive steroid hormone receptor assays in G1 and G2 carcinomas. In contrast, the lack of elastosis in G3 carcinomas may indicate a negative receptor assay. Both findings have a high degree of reliability.     

Expression of epidermal growth factor receptor in benign and malignant primary tumours of the breast

Summary Using the monoclonal antibody EGFR1, normal mammary gland and a series of 213 unselected primary breast tumours were investigated immunohistochemically for expression of epidermal growth factor receptor (EGFR). In normal breast EGFR was expressed in variable patterns in lobular, ductal, and myoepithelial cells. In fibroadenoma, EGFR was detectable in variable numbers of ductal and myoepithelial cells and in stromal fibroblasts. The myoepithelial compartment of 2 cystosarcomas phyllodes also expressed EGFR. Among the 197 carcinomas tested only 20.3% contained EGFR expressing tumour cells which represented a minority in 12.2%, the majority in 2.1%, and the entire neoplastic population in 6.1% of the cases. Again, non-neoplastic ductal remnants often contained EGFR positive myoepithelial and ductal cells whereas stromal fibro-blasts expressed EGFR only occasionally. We conclude that in contrast to the normal state, EGFR-expression is a rather rare phenomenon in breast carcinoma cells, positively correlated with a declining grade of differentiation (p<0.025) and at least occasionally associated with squamous metaplasia within the tumour, that EGFR expression is not exclusively restricted to cells of the epithelial lineage, and that EGFR may have other functions not related to proliferation, since it is commonly detectable in myoepithelial cells.     

Relationship between epidermal growth factor receptor (EGFR) mutation and serum cyclooxygenase-2 Level,and the synergistic effect of celecoxib and gefitinib on EGFR expression in non-small cell lung cancer cells

Epidermal growth factor receptor (EGFR) mutations occur mostly in patients with lung adenocarcinoma; such patients are also more likely to express cyclooxygenase-2 (COX-2), indicating a possible relationship between EGFR mutation and COX-2. The COX-2 and EGFR pathways mutually enhance their procarcinogenic effects in different tumor types. Therefore, simultaneous EGFR and COX-2 inhibition may be a promising therapeutic approach for patients with lung adenocarcinoma. We obtained tissue and serum samples from patients with non-small cell lung cancer (NSCLC) to detect the relationship between EGFR mutation and serum COX-2 level. Subsequently, gefitinib was combined with celecoxib to investigate the efficacy of inhibition in vitro in two NSCLC cell lines: HCC827 (del E746-A750) and A549 (wild-type EGFR). The cells were treated with gefitinib or celecoxib alone or with gefitinib plus celecoxib. Cell proliferation and apoptosis were assessed and correlated with expression of COX-2 and phosphorylated (p)-EGFR. The EGFR mutation rate of the high-COX-2 patients was significantly higher than that in the low-COX-2 patients. Multivariate analysis showed that high COX-2 levels were independently associated with EGFR mutation. Celecoxib and gefitinib inhibited cell growth in both cell lines. At sufficiently high concentrations, celecoxib plus gefitinib significantly mutually enhanced their anti-proliferative and apoptotic effects in both cell lines. At low concentrations, the combination had no additional effects on A549 cells. There was increased down regulation of COX-2 and p-EGFR when both cell lines were treated with high-concentration celecoxib plus gefitinib compared to either agent alone. This study demonstrates that high serum COX-2 levels may indicate EGFR mutations and that the efficacy of combined celecoxib and gefitinib is significantly greater in NSCLC cells with EGFR mutations; at high concentrations, the combination is efficacious in wild-type NSCLC cells.     

Epidermal growth factor receptor (EGFR) mutations in lung cancer: preclinical and clinical data

Lung cancer leads cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC), the most prevalent subtype of this recalcitrant cancer, is usually diagnosed at advanced stages, and available systemic therapies are mostly palliative. The probing of the NSCLC kinome has identified numerous nonoverlapping driver genomic events, including epidermal growth factor receptor (EGFR) gene mutations. This review provides a synopsis of preclinical and clinical data on EGFR mutated NSCLC and EGFR tyrosine kinase inhibitors (TKIs). Classic somatic EGFR kinase domain mutations (such as L858R and exon 19 deletions) make tumors addicted to their signaling cascades and generate a therapeutic window for the use of ATP-mimetic EGFR TKIs. The latter inhibit these kinases and their downstream effectors, and induce apoptosis in preclinical models. The aforementioned EGFR mutations are stout predictors of response and augmentation of progression-free survival when gefitinib, erlotinib, and afatinib are used for patients with advanced NSCLC. The benefits associated with these EGFR TKIs are limited by the mechanisms of tumor resistance, such as the gatekeeper EGFR-T790M mutation, and bypass activation of signaling cascades. Ongoing preclinical efforts for treating resistance have started to translate into patient care (including clinical trials of the covalent EGFR-T790M TKIs AZD9291 and CO-1686) and hold promise to further boost the median survival of patients with EGFR mutated NSCLC.     

Epidermal growth factor receptor domain II, IV, and kinase domain mutations in human solid tumors

Mutations that may predict response to adenosine 5-triphosphate (ATP)-mimetic epidermal growth factor receptor (EGFR) inhibitors occur in the EGFR kinase domain in lung adenocarcinomas and bronchioloalveolar carcinomas (BACs). Data on the frequency of EGFR mutations are sparse in other human tumors. Apart from the deletion mutant EGFRvIII, little is known about the frequency of mutations that encode for the EGFR extracellular domains II and IV that participate in receptor dimerization and formation of the tethered (autoinhibited) receptor conformation. We investigated 566 human neoplasms consisting of various histological types for mutations in exons 6, 7 (encode domain II), 14, 15 (domain IV), 18, 19, and 21 (the kinase domain) using denaturing high-performance liquid chromatography (DHPLC). Approximately 4,500 EGFR exons were screened for the presence of a mutation, and samples with an abnormal finding in DHPLC were sequenced. Only one mutation was found in the extracellular domain IV (glioblastoma), and none in domain II. Eight (11%) out of the 40 lung adenocarcinomas, or 33 BACs, investigated had exon 19 or 21 mutation in the kinase domain, but no mutations were found in other tumor types. Most of the lung cancers with mutated EGFR had three to six copies of the mutated gene in fluorescence in situ hybridization. We conclude that mutations of the EGFR kinase domain and the cysteine-rich extracellular domains are infrequent in most types of human cancer apart from lung adenocarcinoma. Mutated EGFR is usually not amplified in lung cancer.     

Expression of epidermal growth factor and its receptor in rabbits with ischaemic acute renal failure

Urinary immunoreactive epidermal growth factor (EGF) levels decrease, and renal immunoreactive EGF levels increase in rats with ischaemic acute renal failure (ARF). We investigated the immunohistochemical localization of EGF and EGF receptor in rabbits with ischaemic ARF to clarify the significance of renal EGF. Male New Zealand White rabbits underwent right nephrectomy prior to a 60 min renal artery clamp. At 3, 6, 24, 48, 72 and 96 h after ischaemia, serum urea nitrogen and serum creatinine were determined. Guinea pig anti-rabbit EGF antibody and monoclonal anti-EGF receptor antibody were used for the primary incubation. EGF was immunolocalized to the ascending limb of Henle and the distal convoluted tubule in the normal right kidneys. However, in the post ischaemic left kidneys at 6, 24, 48 and 72 h, immunoreactivity of EGF was associated with proximal tubules. In the normal kidneys, antibody to EGF receptor reacted with distal tubules and collecting ducts. In the ischaemic kidneys, EGF receptor was localized in the basolateral membrane in the proximal tubules. The expression of EGF and EGF receptor in renal tubules may play an important role in repair following ischaemic renal damage.     

Transforming growth factor alpha and epidermal growth factor in human pancreatic cancer.

Overexpression of the epidermal growth factor receptor (EGFR) has been reported as an important molecular abnormality in human pancreatic cancer. There is in vitro evidence that simultaneous overproduction of one of its ligands, transforming growth factor alpha (TGF-alpha), might result in an autocrine loop with an increased proliferation signal. We analysed by immunocytochemical staining a retrospective series of human pancreatic cancers, chronic pancreatitis, and normal fetal and adult pancreatic tissues for the presence of TGF-alpha and epidermal growth factor (EGF). Ductal epithelial cells showed TGF-alpha immunoreactivity in both normal tissue and chronic pancreatitis, and 95 per cent of tumours showed strong immunoreactivity. In contrast, EGF immunoreactivity was not found in normal pancreas, but was expressed in 12 per cent of pancreatic carcinomas. Well-defined areas of EGF immunoreactivity in exocrine ducts showing reactive changes in pancreatitis might represent a benign response to tissue damage similar to that previously described in the gastric mucosa.     

Immunohistochemical detection of the epidermal growth factor receptor in paraffin-embedded human tissues.

Expression of the epidermal growth factor (EGF) receptor was evaluated by immunohistochemical staining of formalin-fixed, paraffin-embedded tumour tissues employing two antibodies raised to short synthetic peptides from the cytoplasmic domain of the molecule. Both antibodies gave concordant staining of a series of bladder cancers known to express or lack EGF receptors. There was no cross-reaction with the related c-erbB-2 protein, which was also over-expressed in some cases. Cancers with EGF receptor expression also expressed high levels of TGF-alpha, a receptor agonist.