Original contributionEpidermal growth factor receptor: a novel biomarker for aggressive head and neck cutaneous squamous cell carcinoma☆
Section snippets
Background
Squamous cell carcinoma (SCC) is the second commonest cutaneous malignancy, with 60% occurring in the head and neck region. Most primary SCCs are curable. However, there is a 14% incidence of metastasis for cutaneous SCC in the head and neck, which carries a mortality of up to 40% [1], [2], [3]. Histologic parameters such as tumor depth, degree of differentiation, perineural spread, and vascular and lymphatic invasion in the primary SCC are known to be associated with worse prognosis [3].
Patient selection
Patients with head and neck cutaneous SCCs treated at the Wellington Regional Plastic, Maxillofacial, and Burns Unit over the past decade were identified from our prospective head and neck database. Fifty-four cases of SCC treated between 1998 and 2005 were retrieved from the archives at the Department of Pathology, Hutt Hospital. There were 14 cases of primary SCC with concurrent or subsequent metastasis (PM group), 15 cases of metastatic SCCs (M group), and 25 primary SCCs without metastasis
Results
The clinicopathologic features of the specimens are presented in Table 2. There was no significant difference in these features between the P and PM groups.
Immunoreactivity to EGFR was detected in all primary SCCs. In the P group, 3 (12%) cases exhibited weak, 13 (52%) showed moderate, and the remaining 9 (36%) displayed strong staining intensity. The staining was moderate and strong in 3 (21%) and 11 (79%) cases of the PM group, respectively. PM was significantly associated with overexpression
Discussion
EGFR has been found to be overexpressed in many epithelial malignancies including carcinomas of the colorectum, stomach, esophagus, pancreas, oropharynx, and non–small cell carcinoma of the lung [11]. The mechanism that leads to protein overexpression appears varied. Our study shows that EGFR overexpression is significantly associated with metastatic potential in head and neck cutaneous SCC. In addition, our results also suggest that EGFR overexpression in cutaneous SCC is independent of gene
Acknowledgment
We are grateful to Professor Chris Sissons at the Wellington School of Medicine & Health Sciences for access to the facilities in his laboratory for some aspects of this project, and Paul Oei at Innovative Genetic Diagnosis (IGENZ; Auckland, New Zealand) for his expertise and technical support in FISH.
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We thank the Reconstructive Plastic Surgery Research Foundation and the Sir William and Lady Manchester Trust for their financial support.