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EGFR, but not COX-2, protein in resected pancreatic ductal adenocarcinoma is associated with poor survival.

Journal article
Authors Johan Bourghardt Fagman
David Ljungman
Peter Falk
Britt-Marie Iresjö
Cecilia Engström
Peter Naredi
Kent Lundholm
Published in Oncology letters
Volume 17
Issue 6
Pages 5361-5368
ISSN 1792-1074
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Pages 5361-5368
Language en
Links dx.doi.org/10.3892/ol.2019.10224
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords EGFR, COX‑2, survival, pancreatic cancer
Subject categories Cancer and Oncology

Abstract

The effects of EGFR and COX-2 protein overexpression on clinical outcomes in pancreatic ductal adenocarcinoma (PDAC) patients remains unclear. Therefore, the aim of the present study was to evaluate the protein expression of epithelial growth factor receptor (EGFR) and cyclooxygenase-2 (COX-2) in tumor cells in surgically resected PDAC, in comparison with clinicopathological characteristics and clinical outcomes. Immunohistochemical staining of formalin-fixed paraffin-embedded tissue derived from surgically resected tumors was performed. Tissue slides were evaluated for membrane wild-type EGFR and cytoplasmic COX-2 staining using a histoscore system. Statistical associations between EGFR and COX-2 staining and clinicopathological characteristics were examined to predict survival. In a cohort of 32 resected PDAC patients, high EGFR protein expression in tumor cells was significantly associated with shorter median overall survival (7.9 vs. 39.2 months, P=0.0038). The corresponding hazard ratio (HR) for patients with high EGFR protein expression in tumor cells was 3.12 [95% confidence interval (CI): 1.39-7.00, P=0.006]. COX-2 protein expression was not associated with survival (22.6 vs. 24.5 months P=0.60; HR 1.22 95% CI: 0.59-2.51, P=0.60). Following multivariate Cox regression analysis, high EGFR protein expression in tumor cells (P=0.043) remained as significant independent prognostic factor for survival. In conclusion, high wild-type EGFR protein expression, but not COX-2 protein expression, in tumor cells is a prognostic factor for reduced overall survival following pancreatic tumor resection, supporting a role for EGFR in identifying resected patients that may benefit from EGFR-targeted therapy.

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