title: Epidermal growth factor receptor copy number alterations correlate with poor clinical outcome in patients with head and neck squamous cancer.
abstract: OBJECTIVE
  Overexpression of epidermal growth factor receptor (EGFR) is common in head and neck squamous cell carcinoma (HNSCC). Recent studies showed that EGFR inhibitors are effective for patients with HNSCC. This study analyzed the genetic nature of EGFR gene in HNSCC and its clinical correlations.
  
  
  METHODS
  The EGFR gene copy numbers in 134 HNSCC tumors were determined using quantitative real-time polymerase chain reaction. The status of EGFR gene copy numbers was analyzed with clinical parameters including clinical outcome. Mutation status of EGFR exons 18, 19, and 21 was determined in the HNSCC tumors.
  
  
  RESULTS
  Aberrant EGFR copy numbers were found in 32 (24%) of 134 tumors, including 22 (17%) with increased copy number and 10 (7%) with decreased copy number. Patients whose tumors had EGFR copy number alterations (particularly patients with increased copy numbers) had significantly poorer overall, cancer-specific, and disease-free survivals compared with patients with normal copy numbers (P < .0001). At 5 years after initial diagnosis, 20 (91%) of the 22 patients with increased copy numbers died of disease compared with 30 (29%) of the 102 patients with normal copy number. No mutations on EGFR exons 18, 19, and 21 were detected in any of the tumors.
  
  
  CONCLUSIONS
  A subset of HNSCC manifests EGFR copy number alterations, and this is associated with a poor clinical outcome, suggesting a biologic role of the alterations. The rare mutation or small deletion at EGFR exons 18 to 21 indicates a minimal role of these events in HNSCC.
authors.affiliation: Molecular Biology Laboratory and Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kawaguchi
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Jelinek
authors.forename: Hongli
authors.initials: H
authors.lastname: Tang
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.forename: Wenhua
authors.initials: W
authors.lastname: Lang
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Issa
authors.forename: J Jack
authors.initials: JJ
authors.lastname: Lee
authors.forename: Li
authors.initials: L
authors.lastname: Mao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000235:genetics* / Q000401:mortality; D066246:ErbB Receptors / Q000032:analysis / Q000235:genetics*; D005260:Female; D018628:Gene Dosage; D006258:Head and Neck Neoplasms / Q000235:genetics* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009154:Mutation
chemical_list: D066246:ErbB Receptors