title: Is immunohistochemical epidermal growth factor receptor expression overestimated as a prognostic factor in head-neck squamous cell carcinoma? A retrospective analysis based on a tissue microarray of 365 carcinomas.
abstract: Epidermal growth factor receptor is overexpressed in more than 80% of head-neck squamous cell carcinoma. Its role as an independent prognostic marker is discussed controversially. No standardized evaluation methods are reported. The aim of our study was to analyze the prognostic relevance of epidermal growth factor receptor expression, using a tissue microarray with more than 300 tumor samples. Epidermal growth factor receptor expression was analyzed by immunohistochemistry and fluorescence in situ hybridization based on a tissue microarray of 365 head-neck squamous cell carcinomas with complete clinicopathologic and follow-up data. Multiple independent observers blinded for clinical data evaluated epidermal growth factor receptor immunostaining semiquantitatively. Cut-off scores for positivity were determined systematically by receiver operating characteristic curve analysis and validated by resampling of the data. Epidermal growth factor receptor expression cut-off scores for loco-regional relapse and overall survival were determined to be 60%. No significant correlation with clinicopathologic data was found. Independent significant differences in loco-regional control and overall survival could not be distinguished by epidermal growth factor receptor expression. Epidermal growth factor receptor expression could not be confirmed as a significant independent prognostic marker in head-neck squamous cell carcinoma using a large tissue microarray with 365 head-neck squamous cell carcinomas with complete clinical data, an evaluation based on immunohistochemistry and fluorescence in situ hybridization by multiple independent observers and systematic determination of cut-off scores.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University Hospital, 4031 Basel, Switzerland. cfischer@uhbs.ch
authors.forename: Claude
authors.initials: C
authors.lastname: Fischer
authors.forename: Inti
authors.initials: I
authors.lastname: Zlobec
authors.forename: Edith
authors.initials: E
authors.lastname: Stöckli
authors.forename: Simone
authors.initials: S
authors.lastname: Probst
authors.forename: Claudio
authors.initials: C
authors.lastname: Storck
authors.forename: Luigi
authors.initials: L
authors.lastname: Tornillo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lugli
authors.forename: Markus
authors.initials: M
authors.lastname: Wolfensberger
authors.forename: Luigi
authors.initials: L
authors.lastname: Terracciano
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D004273:DNA, Neoplasm / Q000032:analysis; D003951:Diagnostic Errors; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D007124:Immunoenzyme Techniques; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; C512478:EGFR protein, human; D066246:ErbB Receptors