Evaluation of epidermal growth factor receptor expression by a new scoring system in head-and-neck squamous cell carcinoma and its association with various pathological prognostic factors

CONTEXT: Squamous cell carcinoma is an aggressive epithelial malignancy of the upper aerodigestive tract comprising 90% of all head-and-neck squamous cell carcinoma (HNSCC). It is the sixth leading cancer worldwide, with approximately 600,000 cases reported annually. It is one of the most common cancers in India. AIMS AND OBJECTIVE: Epidermal growth factor receptor (EGFR) being the most promising marker has potentially offered new methods to prognosticate and plays an essential role in early diagnosis and treatment apart from tumor, node and metastasis staging which has been used till now. Therefore, this study has been undertaken to evaluate the expression of EGFR in HNSCC cases, according to the new scoring system and find its association with various pathological prognostic factors. MATERIALS AND METHODS: Forty-eight resected specimens of oral squamous cell carcinoma were received. Cases were appropriately staged, and paraffin-embedded tumor sections, stained with hematoxylin and eosin, were graded. EGFR expression was evaluated as extent score, intensity score and total score (TS). STATISTICAL ANALYSIS: Data obtained were transferred on to an excel sheet. Chi-square test with and without Yate's correction was employed to compare various parameters. P ≤ 0.05 was taken as critical level of significance. RESULTS: A significant association was observed between TS of EGFR expression and tumor grade but not with tumor stage or lymph node metastasis. CONCLUSION: A significant association of EGFR expression exists with tumor grade as per the new scoring system adopted. High EGFR expression suggests uncontrolled growth which depicts that EGFR upregulation may be an early event during HNSCC carcinogenesis.