Epidermal growth factor receptor tissue expression level as a predictor for the aggressiveness of hv-associated laryngeal carcinoma

الملخص EN

Aim : this study was designed to evaluate the frequency of human papilloma virus (HPV) infection in patients with laryngeal squamous cell carcinoma (LSCQ ) through identification of the viral DNA using PCR analysis and to determine tie tissue lends of epidermal growth factor receptor (EGFR) as a trial to find a relation between HPV infection.

EGFR expression and cliricopathological findings in patients with LSCC.

Patients & Methods : the study corryrised 32 patients with suspected LSCQ 25 males and 7 females with mean age 533+122 ; 25-72 years.

Twenty males were smokers while only 5 were non-smokers.

Patients were subjected to full history taking and finical examination Direct laryngoscopy was performed under light general anesthesia in the operating room for evaluation of the larynx and the entire upper aero digestive tract for accurate clinical staging to determine the full extent of the local spread of the tumor and to obtain tissue biopsy.

Cases were categorized clinically according to TNM classification and only cases with SCC were induced in tie study.

Fresh tumor tissue specimens were divided into two parts, the first was studied and graded pathologically according to Word Health Organization (WHO) and the second was stored at -70^ until processed and examined by PCR technique for tie preserve of HPV-DNA and analyzed for EGFR expression.

Results : squamous cell carcinoma was detected in 29 cases (90.6 %) and 3 cases were excluded off the study ; 21 patients (72.4 %) had lesions dickey staged as stage I while 3 (10.3 %) and 5 (17.3 %) had lesions of stages I and IE, respectively.

Patients had Stage I lesions were significantly (p < 0.05) younger than patients with stage E and EI lesions and 9 lesions were detected in Ron-smokers.

There were 23 (79.3 %) glottis lesions, 2 lesions (6.9 %) were supraglottic and 3 (10.3 %) were subglottic and one case (3.4 %) had an extensive squamous cell cardnoma of the larynx involving the subglottic region, the glottis and the supraglottic areas.

There were 21 (72.4 %) polypoidesions and 8 (27.6 %) ulcerative lesion.

According to WHO densification, 14 specimens were type 1, 9 specimens type 2 and 6 specimens were type 3.

PCR could detect HPV-DNA in 16 (55.2 %) specimens (viral specimens) and could not be detected in tie other 13 specimens (non-viral cases).

Three specimens of WHO type 1, 6 specimens of WHO type 2 and 6 specimens of WHO type 3 were viral specimens.

Mean tissue expression end of EGFR was 377+32.2 f M / mg protein and was significantly increased in viral (547 + 27.8 FM/mg protein) couriered to non-viral cases (168+24.6 f M / mg protein) and in specimens of WHO type 2 and 3 compared to those of type 1.

Moreover, there was a positive significant correlation between the pathological WHO types and presence of viral infection (r = 0.568, p = 0.001) and tie tissue expression lends of EGFR (r = 0.720, p0.00l) and a positive significant correlation between tissue expression of EGFR and tie preserve of viral infection (r=0.595, FKX001).

Using the receiver operating characteristic (ROC) curve analysis judged by tie area under tie curve (AUQ to determine the specificity of tree presence of HPV infection and tissue expression of EGFR as a predictor of cancer aggressiveness manifested as WHO pathological stage revealed that tissue expression of EGFR is more specific (AUC = 0.731) thin the preserve of viral infection (AUC = 0.583).

Conclusion : It could be concluded that laryngeal infection with HPV may predispose to carcinogenesis through activation of certain growth factors as EGF and both were found significantly correlated with the aggressiveness of LSCC with the evil of tissue expression of EGFR being a specific determinant of tumor aggressiveness manifested as pathologic stage.