Prognostic impact of EGF-receptor in papillary thyroid carcinoma

Abstract

Summary In this study of papillary thyroid carcinomas, immunopositivity for EGF-receptor was present in a majority of the cases (96%), although different staining patterns were observed. A distinct membraneous reaction was found in 46%, whereas cytoplasmatic positivity of various degrees was present in 90% of the cases. Strong cytoplasmic EGF-receptor staining was significantly associated with extra-thyroidal growth of the primary tumour (P = 0.009), and it was furthermore related to decreased recurrence free survival (P = 0.006). Membraneous EGF-receptor staining was not associated with recurrence free survival or patient survival. Multivariate Cox analysis showed that lymph node metastases (P = 0.0009) and cytoplasmic EGFreceptor staining (P = 0.0048) was independent indicators of tumour recurrences in this group of surgically treated papillary thyroid carcinomas.The prognosis of patients with papillary thyroid carcinoma has previously been described in several reports (Byar et al., 1979; Tubiana et al., 1985;Carcangiu et al., 1985;Akslen et al., 1991), and the influence of sex, age and tumour stage has been discussed. In addition, certain pathological features such as marked nuclear atypia, necrosis or vascular invasion are also important (Tennvall et al., 1985;Schindler et al., 1991;Akslen et al., 1993). This information may improve the risk estimation for individual patients.In recent years, alterations in various growth factors and their receptors have been established as important features of the neoplastic process (Wynford-Thomas, 1991), among them epidermal growth factor (EGF) and its receptor (EGF-R). EGF is known to induce cell proliferation in several tissues, and its effect is mediated via a tyrosine kinase type of receptor (Carpenter & Cohen, 1979). It has previously been shown by different methods that EGF-receptors are expressed in papillary thyroid carcinomas (Duh et al., 1985;Lemoine et al., 1991;Mizukami et al., 1991; Mizukami et al., 1992), but the biological significance of this finding in terms of patient prognosis is not known. The purpose of the present study was therefore to perform a retrospective immunohistochemical study of EGF-R expression in a series of papillary thyroid carcinomas with special reference to its prognostic importance. Material and methodsPatients This material has been described previously . Briefly, all 263 patients who were surgically treated for thyroid cancer at the Department of Surgery, Haukeland Hospital, University of Bergen in the period 1971-1985 have been studied retrospectively. After histological revision and subtyping of the carcinomas according to the WHO criteria (Hedinger, 1988), 173 cases were found to be papillary carcinomas with a known primary tumour. One of the main results from our previous study was that very few events were observed in tumours with a diameter of 10 mm or below (microcarcinomas according to the WHO criteria). These were therefore excluded, thereby concentrating on clinically significant papillary carcinomas. Sufficient materia...

Expression of the estrogen receptor α, progesterone receptor and epidermal growth factor receptor in papillary thyroid carcinoma tissues

“…Numerous studies have reported that the overexpression of EGFR in an anaplastic, undifferentiated subtype of PTC is associated with a high mortality rate (28)(29)(30)(31). However, little is known about the value of EGFR expression in predicting the prognosis of thyroid carcinoma.…”

Prognostic value of epidermal growth factor receptor, p53 and galectin-3 expression in papillary thyroid carcinoma

“…Mizukami et al 27 reported a significant association between EGFR expression and PTC recurrence. Akslen et al [28][29][30] demonstrated that EGFR expression is a significant and independent prognostic factor in PTC. In multivariate analysis, cytoplasmic EGFR expression showed a significant correlation with tumour infiltration in surrounding thyroid tissue and recurrence-free survival.…”

“…24 Many studies have reported the overexpression of EGFR in an anaplastic, undifferentiated subtype of PTC that is associated with a high mortality rate. [25][26][27][28] However, little is known about the value of EGFR expression in predicting the prognosis of thyroid carcinoma. Mizukami et al 27 reported a significant association between EGFR expression and PTC recurrence.…”

Anaplastic thyroid carcinoma

“…High expression of EGFR appears to be a negative prognostic factor in many types of tumors, but few studies have examined its prognostic role in thyroid cancers (Mizukami et al, 1991). Strong EGFR staining in papillary thyroid cancer was associated with poor prognosis (Akslen et al, 1993). These findings suggest that inhibition of EGFR may have anti-cancer efficacy in ATC.…”