Overexpression of the Her-1 oncogene and its relationship with macroscopic prognostic tumor variables in invasive cervical cancer

Abstract

Abstract: 

Cervical cancer is the leading cause of death in women of reproductive age in developing countries. The treatment of advanced stages is frequently unsatisfactory. Overexpression of the epidermal growth factor receptor (EGFR or Her1) could play a significant role in signaling both tumor genesis and growth. It’s not clearly defined yet its clinical and therapeutic utility or whether it constitutes a predictor of poor prognosis. Therefore, it is of interest to investigate new histoprognostic factors associated with its overexpression.

Retrospective Cohort Study. Samples of tumor tissues were studied from thirty patients who attended the Hospital Nacional de Clínicas, and nine from the Sanatorio Allende, both in Córdoba city. The diagnosis was invasive cervical cancer (epidermal vs. adenocarcinoma?) treated with radical Wertheim Meiggs hysterectomy or radical abdominal trachelectomy. EGFR pharmDx ™ Kit for EGFR (HER1) diagnostic assay was used to determine the overexpression of HER1 on tumoral tissue. Total absence of staining was considered a negative result. Any intensity of cell membrane staining was considered positive, with increasing values ​​from +1 to +3. The following variables were analyzed: tumor stage and size at diagnosis, myocervical involvement, parametrial involvement, and vaginal vault involvement. Student's t test was used for comparison of data. A p-value < 0.05 was considered statistically significant.

On the macroscopic examination: 15 ulcerated, 12 vegetant, 4 infiltrative y 8 combined. Microscopic findings: 2 adenocarcinomas, 1 adenosquamous and 36 squamous cell carcinomas. The higher intensity of HER1 marking was correlated with a larger tumor size at the time of diagnosis (p = 0.012), presentation of the disease in advanced stages, and greater penetration of the tumor into the myocervix (p = 0.032). No significant differences were found in parametrial or vaginal vault involvement.

The overexpression of HER1 would constitute a factor of poor prognosis of the disease that would show a more aggressive behavior of the primary tumor, with faster growth of the lesion, especially at higher intensities of staining. It constitutes a factor whose usefulness in practice should be weighed in subsequent studies to help define new therapeutic strategies: adjuvant chemotherapy, postoperative radiotherapy and / or concurrent chemotherapy.