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Abstract
BackgroundIn this study, we intend to determine the immunohistochemical expression of EGFR in cases of head and neck squamous cell carcinoma and its association with prognostic clinico-pathologic features.MethodsA total of 115 cases of head and neck squamous cell carcinoma treated at Liaquat National Hospital, Karachi, Pakistan, were included in the study. Clinico-pathologic features, risk factors, and recurrence status of cases were evaluated, and EGFR immunohistochemistry was performed.ResultsIn our study, 52 cases (45.2%) of head and neck SCC were positive and 10 cases (8.7%) were focal positive for EGFR expression, while 53 cases (46.1%) were negative for EGFR expression. High EGFR expression (> 70%) was noted in 6.1% (7 cases), while 12.2% (14 cases) and 26.1% (30 cases) revealed 51–70% and 11–50% EGFR expression respectively. On the basis of intensity, strong EGFR expression was noted in 13.9% (16 cases) while 16.5% (19 cases) and 23.5% (27 cases) revealed intermediate and weak EGFR expression respectively. Significant association of EGFR expression was noted with tumor stage and disease-free survival.ConclusionWe found a significant association of EGFR expression with tumor stage and disease-free survivals, which are the most important prognostic factors in head and neck squamous cell carcinoma; therefore, EGFR expression can help as a prognostic biomarker in head and neck squamous cell carcinoma. On the other hand, we suggest that molecular studies should be performed in squamous cell carcinoma of head and neck in our setup to identify patients that can avail response from anti-EGFR therapy.
Highlights
In this study, we intend to determine the immunohistochemical expression of epidermal growth factor receptor (EGFR) in cases of head and neck squamous cell carcinoma and its association with prognostic clinico-pathologic features
Areca nut/gutka chewing has been asserted as a major risk factor attributable to the development of leukoplakia and subsequent squamous cell carcinoma (SCC) of oral cavity
On the basis of intensity, strong EGFR expression was noted in 13.9% (16 cases) while 16.5% (19 cases) and 23.5% (27 cases) revealed intermediate and weak EGFR expression respectively
Summary
We intend to determine the immunohistochemical expression of EGFR in cases of head and neck squamous cell carcinoma and its association with prognostic clinico-pathologic features. With a global incidence of 500,000 per annum, squamous cell carcinoma has been reported to be the most prevalent cancer of the oral cavity [1]. 90 to 95% of oral squamous cell carcinoma (SCC) shows varied degrees of epithelial dysplasia [5]. Molecular carcinogenesis of head and neck squamous cell carcinoma (HNSCC) is attributed to several cytogenetic alterations in oncogenes and receptors for growth factors including p53, p27, p16, cyclin D1, and epidermal growth factor receptor (EGFR) [6, 7]. Squamous cell carcinomas of the head and neck exhibit a varying degree of behavior apropos of cellular growth rate, differentiation, and metastasis. In the era of personalized medicine, it is largely accepted that cancer therapy protocols should be devised in the light of tumor characteristics of loco-regional population
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