The Significance Of EGFR Expression And Mutation In Oral Squamous Cell Carcinoma And Its Effect On The Prognosis

Oral cancer is a malignant tumor which occurs in the oral cavity and its adjacent anatomical structure.In the latest edition of the international classification system of diseases(ICD-10),the oral cancer and pharyngeal cancer are combined into one group.It is commonly known as oral and pharyngeal cancer(OPC),or oral cancer.WHO is the most common form of oral cancer.More than 90% of the oral and maxillofacial malignant tumors were derived from the malignant tumors,including oral squamous cell carcinoma(SCC).From the statistical analysis of pathological data,the incidence of malignant tumors in the head and neck is about 14/10 million,which accounts for the 16%-40% of the malignant tumor of the whole body.The statistical results of 36 units in 26 areas in China show that the oral and maxillofacial malignant tumor is 8.2% of the malignant tumor of the whole body.Because oral has anatomical structure and special environment,maxillofacial rich blood,and maxillofacial and neck lymph node tissue rich,for the routine operation of oral squamous cell carcinoma treatment and chemoradiotherapy basically reached the bottleneck,the 5 year survival rate of patients did not improve much,especially in head and neck squamous cell cancer recurrence or distant metastasis of the patients,5 year survival rate is only 30%-40%.In recent years,with the development of molecular targetedtherapies,individualized treatment in cancer patients is more and more applied in clinic,and material science,computer technology,digital imaging technology and the rapid development of clinical oncology treatment technology of biomedical engineering technology combined more closely,treatment of clinical multidisciplinary team(MDT)the concept is gradually rising,provides a new opportunity for the treatment of oral squamous cell carcinoma.Molecular targeted drug cetuximab(Cetuximab)has been approved for the clinical treatment of squamous cell carcinoma of the head and neck,and has made great achievements.The epidermal growth factor receptor(EGFR)has become a hot target for research.Abnormal activation of EGFR signals stimulates the growth of cells,resulting in abnormal proliferation and differentiation of cells and plays an important role in the development and development of tumor.The mechanism of abnormal activation of EGFR signal mainly includes the amplification of EGFR,the abnormal expression of EGFR protein and the mutation of EGFR gene.In this experiment,the immunohistochemical SP method and the Taqman-ARMS method were used to analyze the expression of EGFR protein and the mutation of the gene.Objective: To study the difference between EGFR overexpression in oral squamous cell carcinoma and normal mucosa tissues,to explore the expression and mutation of EGFR in oral squamous cell carcinoma,and to evaluate its relationship with clinicopathological characteristics and prognosis.Methods :(1)The collection of 42 cases of differentiated tissue of patientswith oral squamous cell carcinoma were collected,and 10 cases of normal oral mucosa specimens were compared.(2)The immunohistochemical SP method in42 cases of patients with oral squamous cell carcinoma tissues and 10 cases of normal oral mucosa tissues were EGFR expression detection.(3)The 42 cases of patients with oral squamous cell carcinoma according to the gender,age,degree of differentiation,clinical stage and lymph node metastasis clinical and pathological features were classified.(4)Selection of 12 cases of locally advanced oral squamous cell carcinoma by Taqman-ARMS method for EGFR gene mutation detection.(5)The use of SPSS17.0 was analyzed by chi square test and Fisher exact probability analysis EGFR overexpression and mutation and the clinical pathologic features,using Kaplan-Meier method and Log rank test for overall survival in patients with and without tumor recurrence were analyzed.All statistical analyses were two-sided,with P < 0.05 with discrimination statistical difference.Results: In 42 cases of oral squamous cell carcinoma,37 cases had abnormal expression,the total expression rate was 88.1%,of which 23 cases(54.8%)had over expression,14 cases(33.3%)had low expression.In 10 normal oral mucosa specimens,EGFR had no expression or only a small amount of expression(positive cell rate < 5%).There was a correlation between EGFR abnormal expression and clinicopathological features only with age(P =0.027).The abnormal expression of EGFR was mainly found in patients younger than 60 years old.There was no significant correlation between EGFR abnormal expression and other clinicopathological features(P > 0.05).In thefollow-up study of patients in the records of the patients diagnosed since the date of emergence of oral squamous cell carcinoma patients with time of postoperative recurrence and death time,statistics showed that the abnormal expression of EGFR in patients with overall survival and recurrence free survival rate had no significant correlation(P > 0.05).12 cases of locally advanced squamous cell carcinoma EGFR gene exon 18-21 mutations were not obvious.Conclusion : EGFR in oral squamous cell carcinoma with high expression rate,but the mutation rate level is low,the abnormal expression of EGFR mainly occurred in less than 60 years of oral squamous cell carcinoma patients.Abnormal expression of EGFR is an important factor in the occurrence and evolution of oral squamous cell carcinoma.However,whether the abnormal expression of EGFR can be a poor prognostic factor in oral squamous cell carcinoma needs further research to confirm.