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KMID : 0350519930460020509
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Journal of Catholic Medical College
1993 Volume.46 No. 2 p.509 ~ p.522
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Expression of Epidermal Gowth Factor Receptor Detected by Immunohistochemical Stain using Alkaline Phosphatase in Gastric Adenocarcinoma of Korean
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Abstract
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During the last few years, a potential role of epidermal growth factor receptor(EGFR) has been intensively investigated in many tumors such as lung carcinoma, breast carcinoma, and urinary bladder carcinoma. However, there was no agreement of the
expression of EGFR with tumor invasiveness and lymph node metastasis in gastric adenocarcinoma, which is the most important in Korea because of its high incidence rate among the cancers.
The purpose of this study was to find out the relationship between the expression of EGFR and clinicopathologic findings, and the survival of the patients with gastric adenocarcinoma.
We used an improved immuohistochemical staining method for identification of EGFR in formalin-fixed paraffin-embedded section of 104 human gastric adenocarcinomas and 50 noncancerous tissues obtained from same patients, using monoclonal antibody
against
EGFR. We used stable pepsin and avidin alkaline phosphatase to increase the accuracy and to reduce the staining time.
@ES The results were as follows :
@EN 1. The procedure from dewaxing to crystal mounting could be performed in about one hour by author´s method, which was easy to interpret, and to eliminate the background staining, moreover to save reagents and immunochemicals.
2. Immunoreactivity of EGFR was detected in 53.8%(56/104) of gastric adenocarcinomas and in 12.0%(6/50) of noncancerous gastric tissues, but it was not found in 30 normal gastric tissues. On noncancerous tissues, parietal cell, mucous cells and
capillary endothelium showed focal positive activity. Immunoreactivity of EGFR was demonstrated in 25.0%(4/16) of early gastric carcinomas, while it was present in 59.1%(52/88) of advanced gastric carcinomas(Chi-square test, P<0.05).
3. The positivity of EGFR was gradually increased from 25.0% of stage 1, 45.8% of stage 2, 61.8% of stage 3 to 77.8% of stage 4 (Bartholomew test, P<0.01). Moreover the positivity was gradually increased increased according to tumor invasion and
lymph
node metastasis (Bartholmew test, P<0.01, P<0.05). But we could not find out the relationship of the expression of EGFR with histological type, distant metastasis, localization of tumor, age ad sex.
4. There was no correlation of the staining percentage of EGFR with clinical stage, tumor invasion, lymph node metastasis, and distant metastasis. The staining intensity was in inverse proportion to clinical stage and lymph node metastasis
(measure of
association, gamma, P<0.01, P<0.01), while no correlation was observed with distant metastasis. The staining intensity of cancer cells was variable, however, it was generally stronger than that of noncancerous tissues.
5. The patients with EGFR-positive adenocarcinoma had much worse prognosis than those with EGFR-negative adenocarcinoma(log-rank test, P<0.01). The mean survival duration of the patients with EGFR-positive was shorter than those with
EGFR-negative
(29.7±15.6 months vs. 46.3±19.7 months, t-test, P<0.05).
These results suggested that this improved immunohistochemical technique offers a rapid, economic, reliable and sensitive method for detection of EGFR. And the expression of EGFR may play an important role in the tumor invasion and lymph node
metastasis
but not in distant metastasis, and also may serve as a useful prognostic marker of malignancy in patients with gastric adenocarcinoma of Korean.
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KEYWORD
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