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The role of epidermal growth factor receptor as progression factor in cervical intraepithelial neoplasia and squamous cell carcinoma



Abstract

Background: Cervical carcinoma is the most common cancer with a prevalence of 28.6% of all cancers in women in Indonesia and is one of the leading causes of death among gynecologic malignancies. Prevention and understanding are needed in terms of initiation and development of precancerous lesions into cervical cancer. About 90% of cervical cancers are squamous cell carcinomas that develop from intraepithelial neoplasia. Epidermal Growth Factor Receptor (EGFR) is an expression product of the proto-oncogene c-erbB-1 (HER-1), which plays a role in the proliferation, differentiation and acceleration of the transformation of malignant cells. This study aimed to prove the role of EGFR as a progression factor of cervical intraepithelial neoplasia and cervical squamous cell carcinoma.

Methods: The study design was a cross-sectional analytic observational study, with a total sample of 36, which was taken from biopsy or surgery from patients with cervical intraepithelial neoplasia (CIN) and cervical invasive squamous cell carcinoma (SCC), whose tissues were examined at the Anatomical Pathology Laboratory, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital. Histopathological diagnosis and determination of the type of malignancy were carried out by staining with Hematoxylin and Eosin (H & E). The immunohistochemical stain evaluated EGFR expression.

Results: The age range of CIN was 21-48 years and SSC 33-61 years, mean age 41.8 ± 10.55 years. A total of 16 (44.4%) showed CIN namely 9 (25%) low-grade CIN, 7 (19.4%) high-grade CIN, and 20 (55.6%) SCC. There was a significant difference in the expression of EGFR at low-grade CIN, high-grade CIN and SCC (p = 0.004). There was a significant difference in EGFR expression between low-grade CIN and high-grade CIN (p = 0.035) and between low-grade CIN and SCC (p = 0.003). There was no significant difference in EGFR expression between high-grade CIN and SCC (p = 0.441).

Conclusion: EGFR has a role as a progression factor in CIN and SCC. There was no difference in the expression of EGFR between high-grade CIN and SCC, probably because in this study, carcinoma in situ was also included in high-grade CIN.

Keywords: cervical intraepithelial neoplasia EGFR squamous cell carcinoma

References

  1. Soonthornthum T, Arias-Pulido H, Joste N, Lomo L, Muller C, Rutledge T, et al. Epidermal growth factor receptor as a biomarker for cervical cancer. Ann Oncol. 2011;22(10):2166–78. Available from: http://dx.doi.org/10.1093/annonc/mdq723
  2. Modinou O, Liaropoulos L, Kaitelidou D, Kioulafas K, Theodoraki E-M. Management of Precancerous Lesions of the Uterine Cervix according to Demographic Data. ISRN Obstet Gynecol. 2010/10/27. 2011;2011:301680. Available from: https://pubmed.ncbi.nlm.nih.gov/21637358
  3. Wright TC, Ronnett BM, Kurman RJ, Ferenczy A. Precancerous Lesions of the Cervix [Internet]. Blaustein’s Pathology of the Female Genital Tract. Springer US; 2011. p. 193–252. Available from: http://dx.doi.org/10.1007/978-1-4419-0489-8_5
  4. Li Q, Tang Y, Cheng X, Ji J, Zhang J, Zhou X. EGFR protein expression and gene amplification in squamous intraepithelial lesions and squamous cell carcinomas of the cervix. Int J Clin Exp Pathol. 2014;7(2):733.
  5. Momenimovahed Z, Salehiniya H. Incidence, mortality and risk factors of cervical cancer in the world. Biomed Res Ther. 2017;4(12):1795. Available from: http://dx.doi.org/10.15419/bmrat.v4i12.386
  6. Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences; 2014.
  7. Vet JNI, de Boer MA, van den Akker BEWM, Siregar B, Lisnawati, Budiningsih S, et al. Prevalence of human papillomavirus in Indonesia: a population-based study in three regions. Br J Cancer. 2008;99(1):214–8. Available from: https://pubmed.ncbi.nlm.nih.gov/18609756
  8. Kashyap N, Krishnan N, Kaur S, Ghai S. Risk Factors of Cervical Cancer: A Case-Control Study. Asia-Pacific J Oncol Nurs. 2019;6(3):308–14. Available from: https://pubmed.ncbi.nlm.nih.gov/31259228
  9. Iida K, Nakayama K, Rahman MT, Rahman M, Ishikawa M, Katagiri A, et al. EGFR gene amplification is related to adverse clinical outcomes in cervical squamous cell carcinoma, making the EGFR pathway a novel therapeutic target. Br J Cancer. 2011/07/05. 2011;105(3):420–7. Available from: https://pubmed.ncbi.nlm.nih.gov/21730982
  10. Trimble CL, Clark RA, Thoburn C, Hanson NC, Tassello J, Frosina D, et al. Human papillomavirus 16-associated cervical intraepithelial neoplasia in humans excludes CD8 T cells from dysplastic epithelium. J Immunol. 2010/10/29. 2010;185(11):7107–14. Available from: https://pubmed.ncbi.nlm.nih.gov/21037100
  11. Kurman J, Carcangiu M, Herrington C, Young R. WHO Classification of Tumor of Female Reproductive Organs. 4th ed. Lyon: International Agency for Research on Cancer (IARC); 2014. 172–182 p.
  12. Sasaki T, Hiroki K, Yamashita Y. The role of epidermal growth factor receptor in cancer metastasis and microenvironment. Biomed Res Int. 2013/08/07. 2013;2013:546318. Available from: https://pubmed.ncbi.nlm.nih.gov/23986907
  13. Singh S, Yadav S, Verma A, Sarin N. Expression of epidermal growth factor receptor in squamous cell carcinoma of uterine cervix. Clin Cancer Investig J. 2019;8(6):227. Available from: http://dx.doi.org/10.4103/ccij.ccij_69_19
  14. Viswanath L, Naveen T, Siddanna P, Chetana P, Geethasree M, Sridhar P, et al. Epidermal growth factor receptor (EGFR) overexpression in patients with advanced cervical cancer. J Clin Oncol. 2014;32(15_suppl):e16538–e16538. Available from: http://dx.doi.org/10.1200/jco.2014.32.15_suppl.e16538

How to Cite

Dewi, I. G. A. S. M., Sriwidyani, N. P., & Ekawati, N. P. (2021). The role of epidermal growth factor receptor as progression factor in cervical intraepithelial neoplasia and squamous cell carcinoma. Bali Medical Journal, 10(1), 238–242. https://doi.org/10.15562/bmj.v10i1.2349
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I Gusti Ayu Sri Mahendra Dewi
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Ni Putu Sriwidyani
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Ni Putu Ekawati
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