Open Access

EGFR, but not COX‑2, protein in resected pancreatic ductal adenocarcinoma is associated with poor survival

  • Authors:
    • Johan Bourghardt Fagman
    • David Ljungman
    • Peter Falk
    • Britt‑Marie Iresjö
    • Cecilia Engström
    • Peter Naredi
    • Kent Lundholm
  • View Affiliations

  • Published online on: April 5, 2019     https://doi.org/10.3892/ol.2019.10224
  • Pages: 5361-5368
  • Copyright: © Fagman et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The effects of EGFR and COX‑2 protein overexpression on clinical outcomes in pancreatic ductal adenocarcinoma (PDAC) patients remains unclear. Therefore, the aim of the present study was to evaluate the protein expression of epithelial growth factor receptor (EGFR) and cyclooxygenase‑2 (COX‑2) in tumor cells in surgically resected PDAC, in comparison with clinicopathological characteristics and clinical outcomes. Immunohistochemical staining of formalin‑fixed paraffin‑embedded tissue derived from surgically resected tumors was performed. Tissue slides were evaluated for membrane wild‑type EGFR and cytoplasmic COX‑2 staining using a histoscore system. Statistical associations between EGFR and COX‑2 staining and clinicopathological characteristics were examined to predict survival. In a cohort of 32 resected PDAC patients, high EGFR protein expression in tumor cells was significantly associated with shorter median overall survival (7.9 vs. 39.2 months, P=0.0038). The corresponding hazard ratio (HR) for patients with high EGFR protein expression in tumor cells was 3.12 [95% confidence interval (CI): 1.39‑7.00, P=0.006]. COX‑2 protein expression was not associated with survival (22.6 vs. 24.5 months P=0.60; HR 1.22 95% CI: 0.59‑2.51, P=0.60). Following multivariate Cox regression analysis, high EGFR protein expression in tumor cells (P=0.043) remained as significant independent prognostic factor for survival. In conclusion, high wild‑type EGFR protein expression, but not COX‑2 protein expression, in tumor cells is a prognostic factor for reduced overall survival following pancreatic tumor resection, supporting a role for EGFR in identifying resected patients that may benefit from EGFR‑targeted therapy.

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June 2019
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Copy and paste a formatted citation
APA
Fagman, J.B., Ljungman, D., Falk, P., Iresjö, B., Engström, C., Naredi, P., & Lundholm, K. (2019). EGFR, but not COX‑2, protein in resected pancreatic ductal adenocarcinoma is associated with poor survival. Oncology Letters, 17, 5361-5368. https://doi.org/10.3892/ol.2019.10224
MLA
Fagman, J. B., Ljungman, D., Falk, P., Iresjö, B., Engström, C., Naredi, P., Lundholm, K."EGFR, but not COX‑2, protein in resected pancreatic ductal adenocarcinoma is associated with poor survival". Oncology Letters 17.6 (2019): 5361-5368.
Chicago
Fagman, J. B., Ljungman, D., Falk, P., Iresjö, B., Engström, C., Naredi, P., Lundholm, K."EGFR, but not COX‑2, protein in resected pancreatic ductal adenocarcinoma is associated with poor survival". Oncology Letters 17, no. 6 (2019): 5361-5368. https://doi.org/10.3892/ol.2019.10224