The role of epidermal growth factor receptor as progression factor in cervical intraepithelial neoplasia and squamous cell carcinoma

Abstract

Background: Cervical carcinoma is the most common cancer with a prevalence of 28.6% of all cancers in women in Indonesia and is one of the leading causes of death among gynecologic malignancies. Prevention and understanding are needed in terms of initiation and development of precancerous lesions into cervical cancer. About 90% of cervical cancers are squamous cell carcinomas that develop from intraepithelial neoplasia. Epidermal Growth Factor Receptor (EGFR) is an expression product of the proto-oncogene c-erbB-1 (HER-1), which plays a role in the proliferation, differentiation and acceleration of the transformation of malignant cells. This study aimed to prove the role of EGFR as a progression factor of cervical intraepithelial neoplasia and cervical squamous cell carcinoma.Methods: The study design was a cross-sectional analytic observational study, with a total sample of 36, which was taken from biopsy or surgery from patients with cervical intraepithelial neoplasia (CIN) and cervical invasive squamous cell carcinoma (SCC), whose tissues were examined at the Anatomical Pathology Laboratory, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital. Histopathological diagnosis and determination of the type of malignancy were carried out by staining with Hematoxylin and Eosin (H & E). The immunohistochemical stain evaluated EGFR expression.Results: The age range of CIN was 21-48 years and SSC 33-61 years, mean age 41.8 ± 10.55 years. A total of 16 (44.4%) showed CIN namely 9 (25%) low-grade CIN, 7 (19.4%) high-grade CIN, and 20 (55.6%) SCC. There was a significant difference in the expression of EGFR at low-grade CIN, high-grade CIN and SCC (p = 0.004). There was a significant difference in EGFR expression between low-grade CIN and high-grade CIN (p = 0.035) and between low-grade CIN and SCC (p = 0.003). There was no significant difference in EGFR expression between high-grade CIN and SCC (p = 0.441). Conclusion: EGFR has a role as a progression factor in CIN and SCC. There was no difference in the expression of EGFR between high-grade CIN and SCC, probably because in this study, carcinoma in situ was also included in high-grade CIN.