Expression of Epidermal Growht Factor Receptor in Cervical Tissue and Serum of the Patients with Cervical Neoplasia

Kim, Seung Cheol; Suh, Ji Hyun; Kim, Su Yeon; Moon, Hye Sung; Kim, Hyang Mee; Son, Young Soo; Han, Woon Sup

Abstract

BACKGROUND: Epidermal growth factor receptor (EGFR) is overexpressed in the tissue of various malignancies including carcinoma of the breast, lung, esophagus, cervix, and ovary. In patients with cervical neoplasia, there may be a relationship between the expressions of EGFR in cervical neoplastic tissue and serum.
METHODS
The expression of EGFR was determined in cervical tissues from 23 cervical intraepithelial neoplasia (CIN) patients and 16 invasive cervical carcinoma patients using immunohistochemical staining and the level of serum EGFR ECD (extracellular domain) was measured in serum from 17 CIN patients and 14 cervical carcinoma patients using ELISA (enzyme-linked immunosorbent assay).
RESULTS
The expression of EGFR in cervical tissue was significantly increased as normal cervical tissue progressed to CIN then to invasive cervical carcinoma (p=0.009). And the mean level of serum EGFR according to the histologic diagnosis of normal cervix, CIN, invasive cervical carcinoma was 23.18+/-1.92 fmol/ml, 23.49+/-8.95 fmol/ml, and 30.46+/-19.72 fmol/ml, respectively. The mean level of serum EGFR was higher in invasive cervical carcinoma than that of normal cervix or CIN. But there was no significant statistical difference (p=0.471). Also the mean level of serum EGFR according to the intensity of immunohistochemical staining in negative (-), weakly positive (+), positive (++), and strongly positive (+++) staining was 19.36+/- 3.12 fmol/ml, 20.99+/-3.59 fmol/ml, 29.08+/-16.86 fmol/ml, and 24.34+/-10.35 fmol/ml, respectively. The mean level of serum EGFR in positive (++) and strongly positive (+++) staining was higher than in negative (-) staining, but there was no significant statistical difference (p=0.450).
CONCLUSIONS
The authors believe that the expression of EGFR in cervical neoplastic tissue could be used as a marker for reflecting the malignant transformation of cervical epithelial cells. Although the mean level of serum EGFR in invasive cervical carcinoma was higher than in normal cervix and CIN, and the mean level of serum EGFR in positive (++) and strongly positive (+++) immunohistochemical staining was higher than in negative (-) staining, there was no significant statistical difference, possibly due to the limited number of cases in this preliminary study. So, the authors believe that the level of serum EGFR may have a similar role as a tumor marker like the EGFR expression in cervical neoplastic tissue. This study should be continued further with more cases and the relationship between the level of serum EGFR and prognostic parameters of uterine cervical carcinoma need to be analyzed.