睑板腺癌组织EGFR表达及其与临床特征关系的研究-东南大学学报医学版

睑板腺癌组织EGFR表达及其与临床特征关系的研究

单位：延安大学医学院基础医学院, 陕西延安 716000

分类号：R739.71

出版年·卷·期（页码）：2025·44·第一期（98-104）

摘要：

目的:探讨睑板腺癌组织人表皮生长因子受体(EGFR)的表达及其与肿瘤大小、淋巴结转移及预后的关系。方法:回顾性分析345例睑板腺癌患者的临床资料。通过免疫组织化学方法检测癌组织及癌旁正常组织中的EGFR表达水平。对EGFR阳性表达患者,根据EGFR表达水平(H-score评估)将患者分为低表达组、中等表达组和高表达组,分析其与肿瘤大小、淋巴结转移的关系。采用Kaplan-Meier法用于绘制生存分析曲线,采用Cox回归模型评估预后的独立影响。结果:345例睑板腺癌患者EGFR阳性表达占比55.07%(190/345)。癌组织EGFR的表达水平显著高于癌旁正常组织(P<0.05)。EGFR高表达组中大肿瘤(>3 cm)、有淋巴结转移、深部浸润和Ki-67增殖指数>20%的患者比例显著较中等表达组和低表达组比例高(P<0.05)。肿瘤大小>3 cm的EGFR表达显著高于肿瘤大小≤3 cm的表达(P<0.05);有淋巴结转移的EGFR表达显著高于无淋巴结转移的表达(P<0.05)。ROC曲线分析结果表明,EGFR表达预测肿瘤大小(>3 cm)的AUC为0.795,预测淋巴转移的AUC为0.837,均显示出中等诊断效能。经Cox单因素回归分析和生存分析结果显示,EGFR、肿瘤大小、淋巴结转移、肿瘤分级、Ki-67增殖指数均与睑板腺癌患者预后相关(P<0.05);经Cox多因素回归分析显示,EGFR、肿瘤大小、淋巴结转移、肿瘤分级、Ki-67增殖指数均为影响睑板腺癌患者预后的独立危险因素(P<0.05)。结论:睑板腺癌组织EGFR高表达与肿瘤较大、淋巴结转移及侵袭性病理特征显著相关,且高表达组患者的生存预后较差。EGFR高表达可作为睑板腺癌患者肿瘤进展及预后评估的潜在生物标志物。

Objective: To explore the relationship between human epidermal growth factor receptor(EGFR) expression and tumor size, lymph node metastasis and prognosis in patients with meibomian gland carcinoma. Methods:The clinical data of 345 patients with meibomian gland carcinoma were retrospectively analyzed. EGFR expression levels in cancer tissues and adjacent normal tissues were detected by immunohistochemistry. A total of 190 patients with positive EGFR expression were included. According to the EGFR expression level, the patients were divided into a low expression group of 40 cases, a medium expression group of 85 cases, and a high expression group of 65 cases. Their relationship with tumor size and lymph node metastasis was analyzed. The Kaplan-Meier method was used to draw survival analysis curves, and the Cox regression model was used to evaluate the independent impact on prognosis. Results:Among the 345 patients with meibomian gland carcinoma, the proportion of EGFR positive expression accounted for 55.07%(190/345). The expression level of EGFR in cancer tissue was significantly higher than that in adjacent normal tissue(P<0.05). The proportion of large tumors(>3 cm), lymph node metastasis, deep invasion, and Ki-67 proliferation index >20% in the EGFR high expression group, were significantly higher than those in the medium expression and low expression groups(P<0.05). The expression of EGFR in tumors>3 cm was significantly higher than that in tumors ≤3 cm(P<0.05); the EGFR expression in tumors with lymph node metastasis was significantly higher than that in tumors without lymph node metastasis(P<0.05). ROC curve analysis results showed that the AUC value of EGFR expression in predicting tumor size(>3 cm) was 0.795, and the AUC value of EGFR expression in predicting lymphatic metastasis was 0.837, both showing moderate diagnostic performance. Cox single-factor regression analysis and survival analysis results showed that EGFR, tumor size, lymph node metastasis, tumor grade, and Ki-67 proliferation index were all related to the prognosis of patients with meibomian gland carcinoma(P<0.05). Cox multivariate regression analysis showed that EGFR, tumor size, lymph node metastasis, tumor grade, and Ki-67 proliferation index were all affecting the prognosis of patients with meibomian gland carcinoma(P<0.05). Conclusion: High EGFR expression in patients with meibomian gland carcinoma is significantly associated with larger tumor size, lymph node metastasis and aggressive pathological features, and patients in the high expression group have poorer survival prognosis. High expression of EGFR may be used as a potential biomarker for tumor progression and prognosis assessment in patients with meibomian gland carcinoma.

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