The Effect Of EGFR And EB 2 Compared In The Clinical Staging Of Nasopharyngeal Carcinoma And Preliminary Investigation Into The Relation With TCM Syndrome Type

Background and ObjectiveThe expression of epidermal growth factor receptor(EGFR) in many kinds of tumors is strong, and is related with the prognosis, however, EGFR on the prognostic value of nasopharyngeal carcinoma (NPC) is still disputing.This study research the primary diagnosis patients of NPC in different TCM(traditional Chinese medical) syndrome type by detecting the expression of EGFR in pathological tissue and EB(epstein barr) virus in venous blood, to explore the relevance of EGFR and the clinical pathological features of nasopharyngeal carcinoma, and compare the function of determinating clinical stage in EGFR and the EB virus, thus seeks to the biochemical indicator which can appraisal the situation of tumor growth for the clinical care and the prognosis judgment. In addition, it preliminary investigated the prognostic role of NPC of TCM syndrome type by detecting the expression of EGFR in pathological tissue of patients with different TCM syndrome type.Mater ialsTissue was collected from patients which were first diagnosed as undifferentiated non-keratinizing NPC by biopsy(60 cases), and patients diagnosed as chronic nasopharyngitis(20 cases) admitted to Guangdong Hosiptal of TCM from December 2006 to February 2010.MethodsThe immunity histochemistry was used to detect the expression of EGFR in the pathological tissue of the patients of NPC and chronic nasopharyngitis, the image on the slides were analyzed with IPP6.0 software to obtain the mean of optical density(MOD) of EGFR, and to obtain the optical density(OD) of EB virus in venous blood, it analyzes the effect of EGFR protein expression and the EB check whether had relationship between the clinical stage and the prognosis or not, using the single-factor and the multi-factor method.Results①Expression of EGFR in chronic nasopharyngitis distributes in prickle cell layer of the nasopharyngeal epithelium, EGFR expressed mainly in the cell membrane, and cell differentiation with the expression of the mature and gradually reduced or disappeared, in the basal layer of cells expressed higher levels, and occasionally there was dust-like distribution in the cytoplasm, compared not in inflammatory cells. EGFR in NPC cells have different levels of expression. The expression of EGFR which presented the strings of beads or discrete-shaped mainly distributed in the membrane surrounding, the thickness of the cytoplasm can occur ranging from varying the number of positive thick granules;②The MOD of EGFR of undifferentiated non-keratinizing nasopharyngeal carcinoma(0.1075±0.0802) was significantly higher than that of chronic nasopharyngitis (0.0608±0.0483), P=0.003;③There was no significant difference between the PhaseⅠPhaseⅡpatients with NPC(p=0.381>0.05),other groups exist significant differences, and with the clinical staging increased, MOD (EGFR) also increases. And clinical stage, gender, age, the course of disease will carry on the multiple correlation regression analysis with MOD(EGFR), knew that MOD(EGFR) and the age and the course of disease hadn't relevance, P values were 0.088,0.073(P>0.05), and gender had a significant negative correlation with MOD(EGFR)(p=0.009 <0.01), namely EGFR in women with NPC was lower expression than men, correlation coefficient is-0.304;And there was a significant positive correlation with clinical stage(p=0.000<0.01), that, as the clinical stage increased, MOD (EGFR) are gradually increasing trend, The correlation coefficient is 0.573;④There was relationship between MOD(EGFR) and T(tumour) staging(p=0.000 <0.01), while no significant differences between T1, T2, T3, but T1, T2, T3 and T4 are significant differences. The MOD (EGFR) of T4 was significantly higher than T1, T2, T3, exempt that, it has nothing.to do with other pathological features; ⑤D(VCA-IgA), OD(EA-IgA) had no significant difference between different clinical stages, analyzing by analysis of variance, p values were 0.408,0.068 (P>0.05). And there was no significant correlation between clinical stage, gender, age, course of disease and the OD (VCA-IgA), OD (EA-IgA) carrying out by multiple regression analysis, P>0.05.It still could not think that OD(VCA-IgA), OD(EA-IgA) in this experiment with clinical stage, gender, age, course of disease have the relevance by stages.⑥he primary diagnosis patients of NPC formed mainly by two TCM syndrome types: phlegm syndrome (including 48.3%) and blood stasis syndrome (including 38.3%). The MOD (EGFR) of phlegm syndrome and heat-toxin syndrome had no significant difference (p=0.659> 0.05), but the MOD (EGFR) of the blood stasis syndrome was significantly higher than phlegm syndrome.By comparing MOD(EGFR) of the NPC patients of three kinds of TCM syndromes and the chronic nasopharyngitis, only MOD (EGFR) of the patients of blood stasis syndrome NPC are significantly different (p=0.000<0.01), significantly higher than that in chronic nasopharyngitis.ConclusionsThe nasopharyngeal carcinoma of TCM syndrome type of turbid phlegm and blood stasis exists high expression of EGFR, the expression of EGFR has the enhancement tendency along with the clinical stages markup, EGFR activation may be related to the pathogenesis and progression of nasopharyngeal carcinoma, EGFR expression may be closely related to proliferation of tumor cell; The EB two examinations have the influential role in NPC screening, but with nasopharyngeal carcinoma tumor burden in the human body there is no clear dose-effect relationship, histological detection of EGFR is better than the EB two examination in reflecting the tumor load in the human body, pathological tissues Immunohistochemical determination of EGFR as a routine test used in clinical application of clinical practice has a certain value. Blood stasis syndrome patients may had worse prognosis than phlegm syndrome and heat-toxin syndrome.