title: Epidermal growth factor receptor overexpression in malignant pleural mesothelioma: prognostic correlations.
abstract: BACKGROUND
  To evaluate epidermal growth factor receptor (EGFR) phenotypic expression and related gene status in malignant pleural mesothelioma (MPM) and to correlate the results with patients' prognosis.
  
  
  METHODS
  Eighty-three cases of MPM specimens were submitted to immunohistochemical (IHC) staining to evaluate the expression of EGFR protein; positive cases were submitted to fluorescence in situ hybridization (FISH) to investigate the gene status. Results were correlated with clinico-pathological characteristics and long-term survival.
  
  
  RESULTS
  Thirty-eight cases (46%) demonstrated a positive IHC reaction [30/57 (52%) epithelial and 8/20 (40%) biphasic whereas sarcomatous MPM were negative]. No association was recorded between EGFR IHC positive staining and age, gender, or asbestos exposure. Three out of 38 (8%) cases submitted to FISH were positive revealing gene amplification or polysomy. Mean follow-up was 15.4  months (range 2-44). Epithelial subtype only was confirmed to affect prognosis (2-years survival rate 40 vs. 18% for non-epithelial subtype, P = 0.042). When epithelial MPM patients were considered, IHC EGFR positive staining was demonstrated to be a negative prognostic factor (2-years survival rate 26 vs. 60% for IHC EGFR negative staining; P = 0.026).
  
  
  CONCLUSIONS
  EGFR overexpression is identified by IHC in 52% of epithelial MPM and is demonstrated to be a factor negatively affecting prognosis. Phenotypic overexpression seems not to be related to gene status alteration.
authors: Thoracic Surgery Unit, University of Eastern Piedmont, Azienda Ospedaliero-Universitaria Maggiore della Carità, C.so Mazzini, 18, Novara, Italy. ottaviorena@libero.it
authors: Ottavio
authors: O
authors: Rena
authors: Luciano R
authors: LR
authors: Boldorini
authors: Erica
authors: E
authors: Gaudino
authors: Caterina
authors: C
authors: Casadio
mesh_terms: D000368:Aged; D066246:ErbB Receptors / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005784:Gene Amplification; D018628:Gene Dosage; D006801:Humans; D007124:Immunoenzyme Techniques; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008654:Mesothelioma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D009154:Mutation / Q000235:genetics; D016066:Pleural Effusion, Malignant / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D010997:Pleural Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors