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High EGFR gene copy number predicts poor outcome in triple-negative breast cancer.

EGFR基因拷贝数高预示三阴性乳腺癌患者预后不良

Park HS,Jang MH,Kim EJ,Kim HJ,Lee HJ,Kim YJ,Kim JH,Kang E,Kim SW,Kim IA,Park SY

Abstract

Epidermal growth factor receptor (EGFR) is frequently overexpressed in triple-negative breast cancer and is emerging as a therapeutic target. EGFR gene copy number alteration and mutation are highly variable and scientists have been challenged to define their prognostic significance in triple-negative breast cancer. We examined EGFR protein expression, EGFR gene copy number alteration and mutation of exon 18 to 21 in 151 cases of triple-negative breast cancer and correlated these findings with clinical outcomes. In addition, intratumoral agreement of EGFR protein overexpression and gene copy number alteration was evaluated. EGFR overexpression was found in 97 of 151 cases (64%) and high EGFR gene copy number was detected in 50 cases (33%), including 3 gene amplification (2%) and 47 high polysomy (31%). Five EGFR mutations were detected in 4 of 151 cases (3%) and included G719A in exon 18 (n=1), V786M in exon 20 (n=1), and L858R in exon 21 (n=3). One case had two mutations (G719A and L858R). High EGFR copy number, but not EGFR mutation, correlated with EGFR protein overexpression. Intratumoral heterogeneity of EGFR protein overexpression and EGFR copy number alteration was not significant. In survival analyses, high EGFR copy number was found to be an independent prognostic factor for poor disease-free survival in patients with triple-negative breast cancer. Our findings showed that EGFR mutation was a rare event, but high EGFR copy number was relatively frequent and correlated with EGFR overexpression in triple-negative breast cancer. Moreover, high EGFR copy number was associated with poor clinical outcome in triple-negative breast cancer, suggesting that evaluation of EGFR copy number may be useful for predicting outcomes in patients with triple-negative breast cancer and for selecting patients for anti-EGFR-targeted therapy.

摘要

表皮生长因子受体(EGFR)在三阴性乳腺癌中常过表达,并成为一种新的治疗靶标。EGFR基因拷贝数的改变和突变有很大的差异,科学家试图定义其在三阴性乳腺癌中的预后意义。我们检测了151例三阴性乳腺癌的EGFR基因拷贝数改变和18-21号外显子的突变,并比较与临床预后的相关性。此外,评价EGFR蛋白过表达和基因拷贝数的肿瘤内一致性。

151例样本中,97例发生EGFR(64%)过表达,50例高EGFR基因拷贝数(33%),其中包括3例基因扩增(2%)和47例多倍体(31%)。

151例样本中的4例(3%)检测到5种突变类型,包括1例18号外显子的G719A突变,1例20号外显子的V786M突变,3例21号外显子的L858R突变。1例样本包括2种突变(G719A和L858R)。

无EGFR突变情况下的EGFR基因拷贝数高,与EGFR蛋白过表达相关。EGFR蛋白过表达和EGFR拷贝数改变的肿瘤内异质性无统计学意义。

三阴性乳腺癌的生存分析中发现,EGFR高拷贝数是无病生存率差的独立预后因素。我们研究显示,在三阴性乳腺癌中,EGFR突变是稀有事件,但是EGFR高拷贝数频繁发生,并且与EGFR过表达相关。

此外,在三阴性乳腺癌中,EGFR高拷贝数与不良临床预后相关,表明评价EGFR拷贝数有利于预测三阴性乳腺癌患者的预后和筛选抗EGFR靶向治疗的患者。

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