title: Increase of epidermal growth factor receptor expression in progression of GERD, Barrett, and adenocarcinoma of esophagus.
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) is a pathology with a wide range of clinical and endoscopic manifestations. Epidermal growth factor receptor (EGFR), found in the epithelium of the digestive tract, plays an important role in epithelial repair and shows increased expression in different neoplasms, including esophageal tumors.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate EGFR expression using immunohistochemistry in esophageal biopsies obtained from patients with GERD, Barrett's esophagus, and adenocarcinoma of the esophagus.
  
  
  METHODS
  EGFR expression was immunohistochemically determined in biopsies from 194 patients with symptoms suggestive of GERD or adenocarcinoma of the esophagus, seen at two Brazilian university hospitals between January 2003 and December 2008. Based on histopathological analysis, patients were divided into three groups: GERD, Barrett's esophagus and adenocarcinoma of the esophagus. EGFR expression was considered positive when staining was detected in the membrane.
  
  
  RESULTS
  Mean age was 55.25 years (range 30-90). Patients with GERD (n = 127) accounted for 65.5% of the sample, compared with 12.4% (n = 24) of patients with Barrett's esophagus and 22.2% (n = 43) of patients with esophageal adenocarcinoma. Immunohistochemical analysis was positive for EGFR in 19.1% of the patients (37/194), divided as follows: 8.7% (11/127) in the GERD group, 25% (6/24) in the Barrett's esophagus group, and 46.5% (20/43) in the esophageal adenocarcinoma group. Statistical analysis revealed significant differences between the three groups (p = 0.0001).
  
  
  CONCLUSIONS
  GERD patients showed lower levels of EGFR expression than patients with Barrett's esophagus or patients with adenocarcinoma of the esophagus, suggesting a direct relationship between EGFR expression and disease progression.
authors.affiliation: Department of Surgery, Post Graduation Program in Digestive Surgery, Hospital de Clínicas de Porto Alegre, Rua Santa Cecília 1373/316 Bairro Santana, CEP 90420-041, Porto Alegre, RS, Brazil. ggpretto@gmail.com
authors.forename: Guilherme
authors.initials: G
authors.lastname: Pretto
authors.forename: Richard Ricachenevsky
authors.initials: RR
authors.lastname: Gurski
authors.forename: Marcelo
authors.initials: M
authors.lastname: Binato
authors.forename: Daniel
authors.initials: D
authors.lastname: Navarini
authors.forename: Wolfgan William Schmidt
authors.initials: WW
authors.lastname: Aguiar
authors.forename: Luise
authors.initials: L
authors.lastname: Meurer
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000378:metabolism*; D004815:Epidermal Growth Factor / Q000235:genetics / Q000378:metabolism*; D004938:Esophageal Neoplasms / Q000378:metabolism*; D005260:Female; D005764:Gastroesophageal Reflux / Q000378:metabolism*; D005786:Gene Expression Regulation; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D004815:Epidermal Growth Factor