Malignant pleural mesothelioma and epidermal growth factor receptor (EGF-R). Relationship of EGF-R with histology and survival using fixed paraffin embedded tissue and the F4, monoclonal antibody

Our plain-English summary of Malignant pleural mesothelioma and epidermal growth factor receptor (EGF-R). Relationship of EGF-R with histology and survival using fixed paraffin embedded tissue and the F4, monoclonal antibody, by H. Dazzi, P.S. Hasleton, N. Thatcher, et al (British Journal of Cancer, 1990).

The study

• Authors: H. Dazzi, P.S. Hasleton, N. Thatcher, S. Wilkes, R. Swindell, A.K. Chatterjee
• Journal: British Journal of Cancer
• Published: 1990;61(6):924-6
• Cited by: 100 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The expression of epidermal growth factor receptor (EGF-R) in 34 formalin fixed paraffin embedded specimens of malignant mesothelioma was examined using the F4 antibody. Eight samples of reactive pleura showed homogenous cytoplasmic staining with the antibody. EGF-R positive cells (greater than or equal to 5%) were found in 68% of the mesotheliomas examined. EGF-R positivity was more commonly seen in the epithelial histological subtype than in the sarcomatous or mixed subtypes. Patients with less than 5% of mesothelioma cells staining positive for EGF-R had a significantly shorter survival (median 299 days) compared with patients whose tumours had a greater number of cells positive for EGF-R (median 446 days) (P = 0.04). However, when the histological subgroup was also taken into consideration (epithelial type had a significantly longer survival than the sarcomatous or mixed) the survival difference in relation to EGF-R positivity was no longer significant (P = 0.08). EGF-R could not be used to distinguish between malignant and benign mesothelial tissue and was not an independent prognostic factor for survival.

In plain English

This laboratory study examined tumour tissue from 34 patients with malignant pleural mesothelioma, removed during chest surgery between 1982 and 1986, plus eight samples of reactive (non-cancerous) pleura. The authors used the F4 antibody to detect epidermal growth factor receptor (EGF-R) in the tissue and compared the staining with tumour type and survival. Asbestos exposure was not examined. Reactive pleura also stained for EGF-R. In 68% of the mesotheliomas, 5% or more of tumour cells stained positive. Staining differed by tumour type (P = 0.003) and was commonest in epithelial tumours. Patients whose tumours had fewer than 5% positive cells had shorter median survival (299 days) than those with 5% or more (446 days; P = 0.04). Survival also differed by tumour type (P = 0.05), with epithelial tumours having better survival than sarcomatous or mixed ones. Once tumour type was taken into account, the EGF-R survival difference was no longer statistically significant (P = 0.08). The authors concluded that EGF-R could not distinguish malignant from benign mesothelial tissue and was not an independent prognostic factor, though their Discussion calls it a prognostic feature.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory (immunohistochemical staining) study of stored paraffin-embedded tissue, with comparison of staining against tumour histology and patient survival
• Who was studied: Tissue specimens from 34 patients with malignant mesothelioma, obtained during thoracotomy between 1982 and 1986 (median age 61, range 36 to 78; 29 male, 5 female; 16 epithelial, 9 sarcomatous, 9 mixed cell type), plus samples from 8 patients with reactive mesothelial proliferation due to pneumothoraces. The authors were based at hospitals in Manchester, UK; the article does not state where the patients were treated.
• Exposure: Asbestos exposure was not studied. The factor examined was the proportion of tumour cells staining for epidermal growth factor receptor (EGF-R) with the F4 monoclonal antibody, grouped as 0-4%, 5-19%, 20-50% and over 50%.
• Main results:
  • In the 8 reactive pleura samples, the mesothelial cells showed even (homogenous) staining for EGF-R inside the cells.
  • In 68% of the 34 mesotheliomas, 5% or more of cells were EGF-R positive. In 14 of 34 (41%), more than half of the cells were positive.
  • EGF-R staining differed between the three histological subgroups (P = 0.003) and was commonest in epithelial mesothelioma. Per Table I, fewer than 5% of cells were positive in 2 of 16 epithelial, 2 of 9 sarcomatous and 7 of 9 mixed tumours.
  • Patients whose tumours had fewer than 5% EGF-R positive cells had a median survival of 299 days. Patients whose tumours had 5% or more positive cells had a median survival of 446 days (P = 0.04).
  • Among patients with EGF-R positive tumours, survival did not differ statistically between the 5-19%, 20-50% and over-50% staining groups (P greater than 0.05).
  • Survival differed between the three histological subgroups (P = 0.05).
  • Patients with epithelial tumours had better survival than those with mixed or sarcomatous tumours, a difference the authors describe as significant.
  • When histological subgroup was taken into account, the survival difference by EGF-R staining was no longer statistically significant (P = 0.08).
• The authors' conclusion: In the article's summary, the authors concluded that EGF-R could not be used to distinguish malignant from benign mesothelial tissue and was not an independent prognostic factor for survival. In the Discussion they also concluded that EGF-R cannot identify the tumour's cell of origin or help tell mesothelioma apart from other cancers spreading to the pleura.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Histology, Monoclonal Antibody, Malignant Mesothelioma, Pleura, Mesothelioma, Histological Subtype.

Related studies

• Therapeutic antitumor efficacy of anti-epidermal growth factor receptor antibody, cetuximab, against malignant pleural mesothelioma — J. Kurai, H. Chikumi, et al. (2012)
• Differential expression of N-cadherin in pleural mesotheliomas and E-cadherin in lung adenocarcinomas in formalin-fixed, paraffin-embedded tissues — A.C. Han, A. Peralta-Soler, et al. (1997)
• Validation of a Gene Expression Test for Mesothelioma Prognosis in Formalin-Fixed Paraffin-Embedded Tissues — A. De Rienzo, R.W. Cook, et al. (2017)
• Epidermal growth factor receptor overexpression in malignant pleural mesothelioma: prognostic correlations — O. Rena, L.R. Boldorini, et al. (2011)
• Discrepancies of asbestos body and fiber content between formalin-fixed and corresponding paraffin embedded lung tissue — B.K. Kuhn, F. Barresi, et al. (2021)
• Increased epidermal growth factor-receptor protein in a human mesothelial cell line in response to long asbestos fibers — J.C. Pache, Y.M. Janssen, et al. (1998)

Browse more research in British Journal of Cancer, or return to medical research.