Epidermal growth factor receptor expression in colorectal adenocarcinoma and their corresponding metastatic sites: immunohistochemical and clinicopathological study

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Abstract

Background

Epidermal growth factor receptor (EGFR) has been detected in a large number of cancers, and its expression has been considered as a factor of poor prognosis and more aggressive clinical outcome.

Purpose

The aim of this study was to assess EGFR expression in primary colorectal carcinoma (CRC), to correlate expression with different clinicopathological parameters, and to correlate EGFR expression in primary tumors with that in corresponding lymph nodes and distant metastases.

Patients and methods

This retrospective study included 200 cases of surgically excised CRC between May 2011 and October 2015. Different clinicopathological parameters were retrieved from their patients’ records. One hundred and fifteen cases had lymph node metastasis. Ninety-two cases had developed distant metastasis during the course of the disease. For each case, one positively charged slide was prepared from the primary tumor, and two additional slides were prepared from the corresponding node and distant site metastases. All the slides were subjected to anti-EGFR immunohistochemistry according to the manufacturer’s protocol.

Results

EGFR expression was observed in 44% of the studied CRC cases. EGFR staining was significantly higher in malignant tissue compared with adjacent transitional mucosa (P<0.001). A statistically significant relation was found between EGFR and some clinicopathological parameters including histological subtypes, grade, lymph node status, and development of recurrence. The agreement between EGFR expression in primary tumors and in nodes and distant metastasis is statistically insignificant; κ agreement was 0.49 and 0.35, respectively.

Conclusion

EGFR expression was significantly higher in CRC compared with adjacent transitional mucosa. EGFR expression was significantly correlated with some prognostic clinicopathological parameters. EGFR expression was discordant between primary tumor and metastatic sites.

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