ORIGINAL ARTICLE
A five-year follow up study of stage I-IV of rectal cancer with an emphasis on epidermal growth factor over-expression
1
Department of Physiology, Institute of Medical Science, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
2
Department of Surgery and Surgical Nursing, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
3
Department of Pathology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Submission date: 2021-01-10
Acceptance date: 2021-04-21
Publication date: 2021-05-21
Pol J Pathol 2021;72(2):124-129
KEYWORDS
TOPICS
ABSTRACT
The key pro-proliferative pathway, based on EGFR-KRAS/BRAF-myc, is seen as the main goal of personalized therapy in rectal cancer. The objective of the study is to assess the EGFR immunoreactivity in rectal cancer and to estimate its relationship with the clinical outcome, especially as a predictor of poor outcomes. Patients: applying exclusion criteria, 102 patients with stage I-IV rectal cancer, who had undergone scheduled surgery during the period 2005-2011, were included in the study. There was a follow-up study with a span of 5 years from the date of the surgery.
Immunohistochemistry using EGFR (EGFR Ab10, Clone111.6) was performed to detect an overexpression of the targeted receptor. Digital analysis of positive reactions of membranes was performed utilizing VisiopharmTM.
The degree of EGFR intensity (log OR 0.854, OR 2.35, 95% Cl: 1.14–4.85, p = 0.021) is a significant factor in the prognosis of death within 2 years of surgery. The OS curve showed a significant decrease after 40 months from the date of surgery in the cases where EGFR had a high expression. The ROC curve for the cancer stage, according to the UICC classification and EGFR expression, in order to predict a 2-year RFS, reached a high specificity value (ROC = 0.81, p = 0.0408).
Immunohistochemical EGFR expression is inexpensive, specific and broadly available.
Immunohistochemistry using EGFR (EGFR Ab10, Clone111.6) was performed to detect an overexpression of the targeted receptor. Digital analysis of positive reactions of membranes was performed utilizing VisiopharmTM.
The degree of EGFR intensity (log OR 0.854, OR 2.35, 95% Cl: 1.14–4.85, p = 0.021) is a significant factor in the prognosis of death within 2 years of surgery. The OS curve showed a significant decrease after 40 months from the date of surgery in the cases where EGFR had a high expression. The ROC curve for the cancer stage, according to the UICC classification and EGFR expression, in order to predict a 2-year RFS, reached a high specificity value (ROC = 0.81, p = 0.0408).
Immunohistochemical EGFR expression is inexpensive, specific and broadly available.
REFERENCES (25)
1.
Cervantes A. Exploring better strategies for EGFR antibodies in colon cancer. Lancet Oncol 2014; 15: 549-550.
2.
Uhlyarik A, Piurko V, Vizkeleti L, et al. EGFR Protein Expression of KRAS Wild-Type Colorectal Cancer: Predictive Value of the Sidedness for Efficacy of Anti-EGFR Therapy. Pathol Oncol Res 2020; 26: 1429-1434.
3.
Cheng L, Ren W, Xie L, et al. Anti-EGFR MoAb treatment in colorectal cancer: limitations, controversies, and contradictories. Cancer Chemother Pharmacol 2014; 74: 1-13.
4.
Pinto C, Di Fabio F, Maiell E, et al. Phase II study of panitumumab, oxaliplatin, 5-fluorouracil, and concurrent radiotherapy as preoperative treatment in high-risk locally advanced rectal cancer patients (StarPan/STAR-02 Study). Ann Oncol 2011; 22: 2424-2430.
5.
Douillard JY. Panitumumab – FOLFOX4 Treatment and RAS Mutations in Colorectal Cancer. N Eng J Med 2013; 369: 1023-1034.
6.
Mayer A, Takimoto M, Fritz E, et al. The prognostic significance of proliferating cell nuclear antigen, epidermal growth factor receptor, and mdr gene expression in colorectal cancer. Cancer 1993; 71: 2454-2460.
7.
Spano JP, Lagorce C, Atlan D, et al. Impact of EGFR expression on colorectal cancer patient prognosis and survival. Ann Oncol 2005; 16: 102-108.
8.
Lam AK, Ong K, Ho YH. Colorectal mucinous adenocarcinoma: the clinicopathologic features and significance of p16 and p53 expression. Dis Colon Rectum 2006; 49: 1275-1283.
9.
Negri FV, Campanini N, Camisa R, et al. Biological predictive factors in rectal cancer treated with preoperative radiotherapy or radiochemotherapy. Br J Cancer 2008; 98: 143-147.
10.
Angulo B, Lopez-Rios F, Gonzalez D. A new generation of companion diagnostics: cobas BRAF, KRAS and EGFR mutation detection tests. Expert Rev Mol Diagn 2014; 14: 517-524.
11.
De Stefano A, Carlomagno C. Beyond KRAS: Predictive factors of the efficacy of anti-EGFR monoclonal antibodies in the treatment of metastatic colorectal cancer. World J Gastroenterol 2014; 20: 9732-9743.
12.
Piton N, Borrini F, Bolognese A, Lamy A, Sabourin JC. KRAS and BRAF Mutation Detection: Is Immunohistochemistry a Possible Alternative to Molecular Biology in Colorectal Cancer? Gastroenterol Res Pract 2015; 2015: 753903.
13.
Skonieczna K, Jawieñ A, Marsza³ek A, Grzybowski T. Mitogenome germline mutations and colorectal cancer risk in Polish population. Arch Med Sci 2020; 16: 366-373.
14.
Sandouk F, Al Jerf F, Bassel Al-Halabi MHD. Precancerous Lesions in Colorectal Cancer. Gastroenterol Res Pract 2013; 2013: 457901.
15.
Feigelson HS, Zeng C, Pawloski PA, et al. CERGEN Study Team. Does KRAS testing in metastatic colorectal cancer impact overall survival? A comparative effectiveness study in a population-based sample. PLoS One 2014; 9 (5): e94977.
16.
Formica V, Roselli M. Targeted therapy in first line treatment of RAS wild type colorectal cancer. World J Gastroenterol 2015; 21: 2871-2874.
17.
Kozłowska-Geller MA, Lewitowicz P, G³uszek S. How does overexpression affect the development and treatment of rectal cancer? Stud Med 2018; 34: 337-341.
18.
Gupta S, Sun H, Yi S, et al. Molecular markers of carcinogenesis for risk stratification of individuals with colorectal polyps: a case-control study. Cancer Prev Res (Phila) 2014; 7: 1023-1034.
19.
Herbst RS, Maddox AM, Rothenberg ML, et al. Selective oral epidermal growth factor receptor tyrosine kinase inhibitor ZD1839 is generally well-tolerated and has activity in non-small cel lung cancer and other solid tumors: results of a phase I trial. J Clin Oncol 2002; 20: 3815-3825.
20.
Hata A, Katakami N., Kitajima N. Successful Cetuximab Therapy After Failure of Panitumumab Rechallenge in a Patient with Metastatic Colorectal Cancer: Restoration of Drug Sensitivity After Anti-EGFR Monoclonal Antibody-Free Interval. J Gastrointest Cancer 2014; 45: 506-507.
21.
Hohla F, Winder T, Greil R, et al. Targeted therapy in advanced metastatic colorectal cancer: current concepts and perspectives. World J Gastroenterol 2014; 20: 6102-6112.
22.
Jeong WJ, Cha PH, Choi KY. Strategies to overcome resistance to epidermal growth factor receptor monoclonal antibody therapy in metastatic colorectal cancer. World J Gastroenterol 2014; 20: 9862-9871.
23.
Karantanos T, Theodoropoulos G, Pektasides D, Gazouli M. Clock genes: their role in colorectal cancer. World J Gastroenterol 2014; 20: 1986-1992.
24.
Kishiki T, Ohnishi H, Masaki T, et al. Impact of genetic profiles on the efficacy of anti-EGFR antibodies in metastatic colorectal cancer with KRAS mutation. Oncol Rep 2014; 32: 57-64.
25.
Lee CH, Tseng PL, Tung HY, et al. Comparison of risk factors between colon cancer and rectum cancer in a single medical center hospital, Taiwan. Arch Med Sci 2020; 16: 102-111.
Share
RELATED ARTICLE
| eISSN: | 2084-9869 |
| ISSN: | 1233-9687 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
