Background: Epidermal growth factor receptor (EGFR) is a transmembrane protein. That is a receptor for members of epidermal growth factor family (EGF family) of extracellular protein ligand. The EGFR is a member of the erb family of receptor, a subfamily of four closely related receptor tyrosine kinase - EGFR (erb B-1), Her2/neu(erb B-2), Her3 (erb B-3) and Her4 (erb B-4). Over expression of EGFR is commonly noted in breast, bladder and lung carcinoma. Amplified EGFR gene has also been observed in a number of high grade brain tumour, glioblastoma multiforme (Grade IV) in particular.

Material and Methods: A retrospective study of four years (2012 October to 2016 September) and one and half years prospective (2016 October to 2018 April) study was carried out in IMS & SUM Hospital in collaboration with Neurosurgery department and the follow up was done for a period of 1 year. All CNS tumours were subjected to squash and frozen section followed by histo-pathologic biopsy. The inclusion criteria were all the glioma cases with the patients’ age ranging from 5 to 85 years. This was further subjected to IHC study of EGFR.

Results and Observation: It was found that EGFR expression was negative in low grade glioma like pilocytic astrocytoma, diffuse astrocytoma, oligodendroglioma and ependymomas, whereas EGFR is was positive in high grade gliomas (grade III & IV) like anaplastic astrocytoma and glioblastoma. Amongst the GBM, 80% were primary which showed 100% EGFR positivity where as only 20% of secondary GBM showed EGFR positivity and amongst the variants of GBM, gliosarcoma showed EGFR negativity in contrast to other subtypes.

Conclusion: EGFR can be used as a prognostic marker in gliomas, especially to distinguish between low grade type and high grade type and primary with secondary GBM. But therapeutic success of tyrosine kinase inhibitor that target EGFR has produced encouraging results.

Study type and design: Hospital based cross sectional study and an observational study.

Keywords: EGFR, Glioma, CNS, GBM, Tyrosine kinase inhibitors.

1. Coons, Albert H., Hugh J. Creech, and R. Norman Jones. “Immunological Properties of an Antibody Containing a Fluorescent Group.” Proceedings of the Society for Experimental Biology and Medicine47, no. 2 (June 1941): 200–202.
2. Saadeh, F. S., Mahfouz, R., & Assi, H. I. (2018). EGFR as a clinical marker in glioblastomas and other gliomas. The International Journal of Biological Markers, 33(1), 22–32.
3. Westphal M, Maire CL, Lamszus K. EGFR as a Target for Glioblastoma Treatment: An Unfulfilled Promise. CNS Drugs. 2017;31(9):723-735.
4. Rude Voldborg, L. Damstrup, M. Spang-Thomsen, H. Skovgaard Poulsen; Epidermal growth factor receptor (EGFR) and EGFR mutations, function and possible role in clinical trials, Annals of Oncology, Volume 8, Issue 12, 1 December 1997, Pages 1197–1206
5. Mondal S, Pradhan R, Pal S, Biswas B, Banerjee A, Bhattacharyya D. Clinicopathological pattern of brain tumors: A 3-year study in a tertiary care hospital in India. Clin Cancer Investig J 2016;5:437-40
6. Masoodi T, Gupta RK, Singh JP, Khajuria A. Pattern of central nervous system neoplasm: A study of 106 cases. JK Pract 2012;17:42-6.  
7. Aryal G. Histopathological pattern of central nervous system tumor: A three year retrospective study. J Pathol Nepal 2011;1:22-5. 
8. Wesseling P, Capper D. Neuropathol Appl Neurobiol. 2018 Feb; 44(2):139-150.
9. Ohgaki H, Kleihues P. Genetic pathways to primary and secondary glioblastoma. Am J Pathol 2007;170:1445-53.
10. Lang F.F., Miller D.C., Koslow M., and Newcomb E.W. (1994). Pathways leading to glioblastoma multiforme: a molecular analysis of genetic alteration in 65 astrocytic tumors. J Neurosurg81,427–436.
11. Immunohistochemical Staining Methods, 5^th George L Kumar, Lars Rudbeck, DAKO.
12. Rüschoff J, Kerr KM, Grote HJ, Middel P, von Heydebreck A, Alves VA, Baldus SE, Büttner R, Carvalho L, Fink L, Jochum W. Reproducibility of Immunohistochemical Scoring for Epidermal Growth Factor Receptor Expression in Non–Small Cell Lung Cancer: Round Robin Test. Archives of Pathology and Laboratory Medicine. 2012 Dec 27;137(9):1255-61.
13. Liu F, Xu K, Yang H, et al. A novel approach to glioma therapy using an oncolytic adenovirus with two specific promoters. Oncol Lett. 2017;15(3):3362-3368.
14. Xu H, Zong H, Ma C, et al. Epidermal growth factor receptor in glioblastoma Oncol Lett. 2017;14(1):512-516.
15. Lee KS, Choe G, Nam KH, et al. Immunohistochemical classification of primary and secondary glioblastomas Korean J Pathol. 2013;47(6):541-8.

Debahuti Mohapatra

Prof. & Head, Dept. of Pathology, IMS & SUM Hospital, BBSR- 751003, Odisha, India

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