Evaluating the value of Amphiregulin, Phosphatase and Tensin Homologue (PTEN) and P21 Expression for Anti-EGFR Treatment in Metastatic Colorectal Carcinoma

Document Type : Research Articles

Authors

1 Department of Clinical Oncology & Nuclear Medicine, Faculty of Medicine, Zagazig University, Egypt.

2 Department of Medical Oncology, Faculty of Medicine, Zagazig University, Egypt.

3 Department of Clinical Oncology & Nuclear Medicine, Elmabara Hospital of Zagazig, Health Insurance Organization, Zagazig, Egypt.

4 Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt.

5 Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt.

6 Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.

7 Department of Pathology, Faculty of Medicine, Zagazig University, Egypt.

Abstract

Background: Despite the significant progress in target therapy for the treatment of metastatic colorectal carcinoma (mCRC), the overall survival isn’t satisfactory. Methods: We assessed the expression of Amphiregulin, PTEN, and P21 in sections from 23 paraffin blocks prepared from 23 patients with left-sided mCRC using immunohistochemistry (IHC). The relationship between their level of expressions, clinicopathological parameters, response to anti-EGFR, and prognosis were analyzed. Results: High Amphiregulin, PTEN and low P21 expression levels were associated with low tumor grade (p= 0.038 and 0.025 respectively), better response to anti-EGFR treatment (p <0.001), and favorable outcome {progression-free survival (PFS) and overall survival (OS)} (p <0.05). There was a direct relation between Amphiregulin and PTEN expressions (phi coefficient=+0.840), while there was an inverse relation between P21expression and both Amphiregulin (phi coefficient= -0.840) and PTEN expressions (phi coefficient = -1.000), which was statistically significant (P <0.001). Conclusion: High Amphiregulin and PTEN expression levels and low P21 expression levels were associated with better response to anti-EGFR therapy and improved survival outcome. They might be considered predictive markers of response to anti-EGFR therapy in mCRC.

 

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