Expression And Significance Of Epidermal Growth Factor Receptor And Vascular Endothelial Growth Factor Receptor 3 In Chronic Rhinosinusitis With And Without Nasal Polyposis

Objective Observe the expression of epidermal growth factor receptor (EGFR) andvascular endothelial growth factor receptor 3 (VEGFR-3) in chronic rhinosinusitis(CRS) and chronic rhinosinusitis with nasal polyposis (CRS/NP), tell the differencebetween the intensity and the location. Approach the role of EGFR and VEGFR-3 inCRS and CRS/NP, in order to provide a potential rationale of clinical molecularbiological therapy for healing the disease.Methods Thickening mucosae from the ostiomeatal complex (OMC) of 15 definitepatients with CRS (group A) and the nasal polyposis from the OMC of another 15definite patients with CRS/NP (group B) was collected for formalin fixation, and thenfor paraffin imbedding. All of specimens were performed the serial section.Hematoxylin and eosin stain (HE stain) was taken on each specimens in order toidentify the pathologic diagnosis. Immunohistochemical SP method was used todetect the expressions of EGFR and VEGFR-3. We selected multiclonal anti-humanEGFR antibody and multiclonal anti-human VEGFR-3 antibody as the first antibodyfor immunohistochemical stain. Phosphate buffered solution (PBS) instead of the firstantibody for the negative control. Inferior nasal concha mucosae from 11 patientsundergoing submucous resection of nasal septum was selected as the control group.The expressional intensity and the location of EGFR and VEGFR-3 were observedunder the light microscope. Evaluate the intensity of expression according to thestaining degree and the staining area. We semi quantified and expressed the stainingintensity as negative stain (-), weak stain (+), moderate stain (-), or intense stain(+++). SPSS 11.5 system was used to perform the statistical analysis.Result In group A, EGFR positive staining was observed in epithelium mucosae andglandular epithelium, and the stain was located in membrane and cytoplasm; some ofthe inflammatory cells were displayed as positive. There wasn't immunoreactivity in the blood vessel endothelium. VEGFR-3 positive staining was observed in glandularepithelium, located in cytoplasm and nucleus; there was weak stain in cytoplasm andnucleus of the epithelium mucosae. A few of blood vessel endothelium showed weakstain located in cytoplasm and nucleus.In group B, EGFR positive staining was observed in epithelium mucosae locatedin membrane and cytoplasm; there was weak stain in glandular epithelium, and theblood vessel endothelium showed negative.VEGFR-3 positive stain was observed inepithelium mucosae, both the cytoplasm and the nucleus were included in, but theintense of the nucleus was stronger in the great majority of cases. There was moderateto strong immunoreactivity in blood vessel endothelium, including cytoplasm andnucleus, and intense of the nucleus was stronger in the great majority of cases. Someof the glandular epithelium showed weak stain, located in cytoplasm and nucleus.In group C, nearly all of cells were negative for EGFR immunoreactivity, although there was some weak stain in epithelium mucosae individually. The majorityof the glandular epithelium showed moderate stain for EGFR. For VEGFR-3, majorityof the cells were negative in spite of several epithelium mucosae showed weak stain.Some of the glandular epithelium was stained, but they were weaker obviously thanthe cases in experimental group.There was statistical significance during the three groups' epithelium mucosaefor EGFR expression. Both of the intensity of group A and group B were significantlycomparing with the control group (P＜0.05). For VEGFR-3, the intensity of expressionin epithelium mucosae and blood vessel endothelium were both significant in group Bcomparing with control group; the intensity of expression in glandular epithelium wassignificant in group A comparing with control group. Expression of EGFR andVEGFR-3 in the other locations were quiet comparing with control group.Conclusions1. Expression of EGFR and VEGFR-3 was found to heighten abnormally, and both ofthe intensity and the location were different between CRS & CRS/NP. Furthermore, VEGFR-3 was found positive in the inflammatory disease at the first time;2. EGFR system may contribute to the hyperplasia of goblet cells and mucus production in CRS;3. VEGFR-3 system may contribute to hyperplasia and squamous epithelization of theepithelium mucosae, angiogenesis and vegetation of polyposis in CRS/NP;4. EGFR, VEGFR-3 could regard as the target of molecular biological therapy forCRS & CRS/NP in abstracto, especially in the aspect of releasing the inflammationand preventing recurrence.