title: Epidermal growth factor receptor in non-small-cell lung carcinomas: correlation between gene copy number and protein expression and impact on prognosis.
abstract: OBJECTIVE
  The epidermal growth factor receptor (EGFR) is frequently overexpressed in non-small-cell lung carcinoma (NSCLC), and EGFR inhibitors are promising new therapeutic agents. The molecular mechanisms responsible for EGFR overexpression are poorly understood.
  
  
  METHODS
  Gene copy number and protein status of EGFR were investigated in microarrayed tumors from 183 NSCLC patients, including squamous cell carcinoma (SCC; 89 patients) and non-SCC (94 patients) histologies. Protein expression was assessed by immunohistochemistry on a scale from 0 to 400 (percentage of positive cells x staining intensity). Gene and chromosome 7 copy numbers were identified by fluorescent in situ hybridization (FISH).
  
  
  RESULTS
  EGFR protein overexpression was observed in 62% of the NSCLC (25% scored 201 to 300; 37% scored 301 to 400), more frequently in SCC than non-SCC (82% v 44%; P <.001), and in 80% of the bronchioloalveolar carcinomas. The prevalent FISH patterns were balanced disomy (40%) and trisomy (38%) for EGFR gene and chromosome 7 (40%), whereas balanced polysomy was seen in 13% and gene amplification was seen in 9% of the patients. Gene copy number correlated with protein expression (r = 0.4; P <.001). EGFR overexpression or high gene copy numbers had no significant influence on prognosis.
  
  
  CONCLUSIONS
  EGFR overexpression is frequent in NSCLC, is most prominent in SCC, and correlates with increased gene copy number per cell. High gene copy numbers per cell showed a trend toward poor prognosis. It will be important to evaluate EGFR gene and EGFR protein status and signal protein expression to properly interpret future clinical trials using EGFR inhibitors.
authors.affiliation: Department of Pathology, University of Colorado Health Sciences Center, Denver, CO 80262, USA. Fred.Hirsch@uchsc.edu
authors.forename: Fred R
authors.initials: FR
authors.lastname: Hirsch
authors.forename: Marileila
authors.initials: M
authors.lastname: Varella-Garcia
authors.forename: Paul A
authors.initials: PA
authors.lastname: Bunn
authors.forename: Michael V
authors.initials: MV
authors.lastname: Di Maria
authors.forename: Robert
authors.initials: R
authors.lastname: Veve
authors.forename: Roy M
authors.initials: RM
authors.lastname: Bremmes
authors.forename: Anna E
authors.initials: AE
authors.lastname: Barón
authors.forename: Chan
authors.initials: C
authors.lastname: Zeng
authors.forename: Wilbur A
authors.initials: WA
authors.lastname: Franklin
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000235:genetics; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics*; D002294:Carcinoma, Squamous Cell / Q000235:genetics; D002897:Chromosomes, Human, Pair 7; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D018628:Gene Dosage; D018773:Genes, erbB-1; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D011379:Prognosis
chemical_list: D066246:ErbB Receptors