1. Membranous expression of ectodomain isoforms of the epidermal growth factor receptor predicts outcome after chemoradiotherapy of lymph node-negative cervical cancer.
- Author
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Halle C, Lando M, Svendsrud DH, Clancy T, Holden M, Sundfør K, Kristensen GB, Holm R, and Lyng H
- Subjects
- Adult, Aged, Blotting, Western, Carcinoma, Squamous Cell genetics, Cell Membrane metabolism, Chemoradiotherapy, Cohort Studies, ErbB Receptors genetics, Female, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Gene Regulatory Networks, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lymph Nodes metabolism, Lymph Nodes pathology, Middle Aged, Phosphorylation, Prognosis, Protein Isoforms genetics, Protein Isoforms metabolism, Reverse Transcriptase Polymerase Chain Reaction, Treatment Outcome, Uterine Cervical Neoplasms genetics, Carcinoma, Squamous Cell metabolism, Carcinoma, Squamous Cell therapy, ErbB Receptors metabolism, Uterine Cervical Neoplasms metabolism, Uterine Cervical Neoplasms therapy
- Abstract
Purpose: We compared the prognostic significance of ectodomain isoforms of the epidermal growth factor receptor (EGFR), which lack the tyrosine kinase (TK) domain, with that of the full-length receptor and its autophosphorylation status in cervical cancers treated with conventional chemoradiotherapy., Experimental Design: Expression of EGFR isoforms was assessed by immunohistochemistry in a prospectively collected cohort of 178 patients with squamous cell cervical carcinoma, and their detection was confirmed with Western blotting and reverse transcriptase PCR. A proximity ligation immunohistochemistry assay was used to assess EGFR-specific autophosphorylation. Pathways associated with the expression of ectodomain isoforms were studied by gene expression analysis with Illumina beadarrays in 110 patients and validated in an independent cohort of 41 patients., Results: Membranous expression of ectodomain isoforms alone, without the coexpression of the full-length receptor, showed correlations to poor clinical outcome that were highly significant for lymph node-negative patients (locoregional control, P = 0.0002; progression-free survival, P < 0.0001; disease-specific survival, P = 0.005 in the log-rank test) and independent of clinical variables. The ectodomain isoforms were primarily 60-kD products of alternative EGFR transcripts. Their membranous expression correlated with transcriptional regulation of oncogenic pathways including activation of MYC and MAX, which was significantly associated with poor outcome. This aggressive phenotype of ectodomain EGFR expressing tumors was confirmed in the independent cohort. Neither total nor full-length EGFR protein level, or autophosphorylation status, showed prognostic significance., Conclusion: Membranous expression of ectodomain EGFR isoforms, and not TK activation, predicts poor outcome after chemoradiotherapy for patients with lymph node-negative cervical cancer., (©2011 AACR.)
- Published
- 2011
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