Receptor del factor de crecimiento epidérmico (EGFR) en el pronóstico del carcinoma vesical. Experiencia a 5 años

JESÚS MORENO SIERRA, Ma. LUISA MAESTRO DE LAS CASAS, E. REDONDO GONZÁLEZ, C. FERNÁNDEZ PÉREZ, M.T. DEL BARCO BARRIUSO, V. SANZ CASLA, ENRIQUE BLANCO JIMÉNEZ, ÁNGEL SILMI MOYANO, LUIS RESEL ESTÉVEZ

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Archivos Españoles de Urología ›› 2000, Vol. 53 ›› Issue (4) : 323-331.
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Receptor del factor de crecimiento epidérmico (EGFR) en el pronóstico del carcinoma vesical. Experiencia a 5 años

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METHODS: From November 1992 toNovember 1993, a prospective study was conducted on 20controls and 61 patients with bladder carcinoma. EGFRexpression was determined by radioimmunoassay and thecorrelation of the results of histological analysis and theclinical course was analyzed. The follow-up period wasfrom November 1992 to July 1998. The association betweenqualitative variables and the x2 or Fisher exact test wascompared using the hypothesis of the proportional ordinaltrend for the ordinal variables, and the quantitativevariables were analyzed using Student’s t test and/orvariance analysis (ANOVA). Survival was analyzed by theKaplan-Meier method and comparison was performedusing the Breslow exact test. The Cox proportional hazardsregression model was utilized. The SPSS software forWindows 7.0 was used for the analysis.RESULTS: The EGFR values were higher for patientswith bladder carcinoma than in controls (14.48 vs 2.54fmol/mg of protein). EGFR values were higher in patientswith superficial bladder tumor than in those with infiltratingtumors (27.03 fmol/mg vs. 10.05 fmol/mg of protein; p =0.000). Poorly differentiated tumors showed higher valuesof EGFR (6.73, 14.48 and 17.07 fmol/mg of protein forgrades I, II and III, respectively; p <0.05). The EGFRvalues were higher in patients that died from cancerduring follow-up (64.8) than in those who died from othercauses (47.5) and those who are alive and on follow-up(42). An increase in EGFR values did not carry a risk ofdeath from cancer (p = 0.1269; ns). Analysis of the gradeof tumor differentiation showed that for the more aggressivetumor grade, a positive EGFR was a sign of reducedsurvival. Survival in patients with superficial andinfiltrating tumor did not appear to change significantlyaccording to the EGFR value. EGFR determination wasnot useful in predicting recurrence and increased EGFRvalues did not correlate with a higher risk of recurrence.CONCLUSIONS: 1) The normal pattern of EGFRcould not be established. 2) EGFR was not useful inidentifying subgroups at risk of death. 3) Knowledge aboutthese proteins synthesized by oncogenes offers newpossibilities in the treatment of cancer.

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Prognostic factors / Bladder cancer / Molecular biology / Radioimmunoassay

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JESÚS MORENO SIERRA , Ma. LUISA MAESTRO DE LAS CASAS , E. REDONDO GONZÁLEZ , C. FERNÁNDEZ PÉREZ , M.T. DEL BARCO BARRIUSO , V. SANZ CASLA , ENRIQUE BLANCO JIMÉNEZ , ÁNGEL SILMI MOYANO , LUIS RESEL ESTÉVEZ. Receptor del factor de crecimiento epidérmico (EGFR) en el pronóstico del carcinoma vesical. Experiencia a 5 años. Archivos Españoles de Urología. 2000, 53(4): 323-331

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