Clinicopathologic Significances of EGFR Expression at Invasive Front of Colorectal Cancer

Abstract

Background : Epidermal growth factor receptor (EGFR) is frequently expressed in the invasive front of colorectal cancer (CRC), but its clinicopathologic significance remains unclear. We investigated the clinical value of the EGFR expression at the invasive front of CRC. Methods :We performed an immunohistochemical analysis in order to examine the expression and distribution of EGFR in 214 cases of CRC. The EGFR status was considered positive when ≥ 1% of the tumor cells had membranous staining. Results : Overall, an EGFR expression was observed in 144 (67%) cases and it had no significant relationship with the clinicopathologic parameters. However, an EGFR expression at the invasive front was correlated with lymphatic invasion, lymph node metastasis and a high level of serum carcinoembryonic antigen (p = 0.028, p = 0.043, and p = 0.045, respectively). For the budding-positive CRCs liver metastases were found in the cases with an EGFR expression at the budding, but no liver metastasis occurred in the EGFR negative cases at the budding (p = 0.030). Conclusions : An EGFR expression at the invasive front has clinicopathologic significances in patients with CRC. An EGFR expression at tumor cell budding is a pathologic marker that suggests the high potential for liver metastasis in CRC.

Epidermal growth factor receptor intron 1 polymorphism and microsatellite instability in sporadic colorectal cancer

“…Our results showed for the first time that EGFR mRNA and protein levels were lower in both the tumour centre and invasive tumour front of MSI-H tumours than in such samples from MSS tumours. This is in accordance with several studies that showed a smaller number of metastatic lymph nodes in MSI-H patients than MSS patients ( 9 , 47 ), and it could also clarify why MSI-H metastatic CRC is rare ( 48 ). In addition to increased host immunity ( 49 , 50 ), a decrease in EGFR expression in MSI-H CRC could partially explain why these cancers are less aggressive and have a more promising prognosis.…”

“…Epidermal growth factor receptor (EGFR) is a membrane receptor of the receptor tyrosine kinase (ErbBs) family that plays an important role in cell proliferation, survival, differentiation and invasion in sporadic colon cancer ( 3 , 4 ). Several studies have shown that EGFR is overexpressed in approximately 50% of colon tumours ( 5 – 7 ) and there is an increased level of EGFR protein at the invasive tumour front (ITF) in comparison to the tumour centre ( 8 , 9 ). This increased EGFR expression has been related to the presence of tumour budding leading to tumour invasion and other aggressive pathohistological features ( 10 – 13 ).…”