Open Access

Higher nuclear EGFR expression is a better predictor of survival in rectal cancer patients following neoadjuvant chemoradiotherapy than cytoplasmic EGFR expression

  • Authors:
    • Ching‑Chieh Yang
    • Li‑Ching Lin
    • Yu‑Wei Lin
    • Yu‑Feng Tian
    • Chen‑Yi Lin
    • Ming‑Jen Sheu
    • Chien‑Feng Li
    • Ming‑Hong Tai
  • View Affiliations

  • Published online on: November 26, 2018     https://doi.org/10.3892/ol.2018.9756
  • Pages: 1551-1558
  • Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate the prognostic value of cytoplasmic (‑C) and nuclear epidermal growth factor receptor (EGFR‑N) expression in rectal cancer patients following neoadjuvant concurrent chemoradiotherapy (CCRT). A total of 172 newly diagnosed rectal cancer patients post‑neoadjuvant CCRT and curative surgery, treated between January 1998 to December 2008, were included. Pathological tissues used for evaluation were biopsy specimens obtained prior to CCRT, and specimens collected at surgery. EGFR expression in the nucleus and cytoplasm was assessed by immunohistochemistry tests. An intensity of 3+ EGFR reactivity in the cytoplasm (and/or membrane) of tumor cells was defined as overexpression of EGFR‑C. The cutoff percentage of immunoreactive tumor cells for EGFR‑N overexpression was 50%. Expression levels of EGFR‑C and EGFR‑N were further analyzed by clinicopathological features for 5‑year survival disease‑specific survival (DSS), local recurrence‑free survival (LRFS) and metastasis‑free survival (MeFS). The results revealed that 20.9 and 23.3% of the cohort had high EGFR‑N and EGFR‑C expression, respectively. EGFR‑N overexpression was significantly associated with advanced pre‑treatment tumor stage (T3 and 4; P=0.017) and post‑treatment tumor stage (T3 and 4; P<0.001). In univariate analysis, EGFR‑N overexpression was significantly associated with poorer DSS (P=0.0005), MeFS (P=0.0182), and LRFS (P=0.0014). Furthermore, it remained an independent prognosticator of worse DSS [P=0.007, hazard ratio (HR)=2.755] and LRFS (P=0.0164, HR=3.026) in multivariate analysis. Overexpression of EGFR‑N, and not EGFR‑C, may help identify rectal cancer patients who have an increased risk of local recurrence and poor survival following neoadjuvant CCRT.
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February-2019
Volume 17 Issue 2

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Yang CC, Lin LC, Lin YW, Tian YF, Lin CY, Sheu MJ, Li CF and Tai MH: Higher nuclear EGFR expression is a better predictor of survival in rectal cancer patients following neoadjuvant chemoradiotherapy than cytoplasmic EGFR expression. Oncol Lett 17: 1551-1558, 2019
APA
Yang, C., Lin, L., Lin, Y., Tian, Y., Lin, C., Sheu, M. ... Tai, M. (2019). Higher nuclear EGFR expression is a better predictor of survival in rectal cancer patients following neoadjuvant chemoradiotherapy than cytoplasmic EGFR expression. Oncology Letters, 17, 1551-1558. https://doi.org/10.3892/ol.2018.9756
MLA
Yang, C., Lin, L., Lin, Y., Tian, Y., Lin, C., Sheu, M., Li, C., Tai, M."Higher nuclear EGFR expression is a better predictor of survival in rectal cancer patients following neoadjuvant chemoradiotherapy than cytoplasmic EGFR expression". Oncology Letters 17.2 (2019): 1551-1558.
Chicago
Yang, C., Lin, L., Lin, Y., Tian, Y., Lin, C., Sheu, M., Li, C., Tai, M."Higher nuclear EGFR expression is a better predictor of survival in rectal cancer patients following neoadjuvant chemoradiotherapy than cytoplasmic EGFR expression". Oncology Letters 17, no. 2 (2019): 1551-1558. https://doi.org/10.3892/ol.2018.9756