Immunohistochemical Expression of Estrogen Receptor α and Epidermal Growth Factor Receptor in Head and Neck Cancer: Assessing their Prognostic Significance

Abstract

Background: Head-and-neck squamous cell carcinomas (HNSCC) comprise 30% of all cancer cases in India, and shows male preponderance. Risk factors include smoking, betel/areca nut chewing, alcohol intake, and genetic factors. The epidermal growth factor receptor (EGFR) and estrogen receptor α (ERα) play pivotal roles in HNSCC progression, making them potential therapeutic targets.

Objectives: This study aimed to investigate the expression of ERα and EGFR in HNSCC, assessing their potential as prognostic indicators. The research analyzed their expression in correlation with clinicopathological parameters thus aiming to contribute insights for personalized treatment strategies.

Methods: A one-year descriptive study (August 2022 to July 2023) included 30 histologically proven HNSCC cases. Immunohistochemistry staining for EGFR and ERα was performed, and a scoring system (H-Score) was used for quantification. Data analysis utilized SPSS 22.0 software. Results: There were 80% males, with 43% exhibiting moderate tumor differentiation. The lateral border of the tongue was the most common anatomical site (33.3%). Clinicopathologic factors were analyzed in relation to H scores, showing varying patterns across histological grade, lymphocytic infiltration, lymphovascular invasion, metastasis, and two-year disease-free survival.

A significant association was observed between two-year disease-free survival and recurrence (p value =0.042).

Discussion: The study contributed to understanding HNSCC by exploring epidemiology, clinical characteristics, molecular factors, and prognostic markers. The male predominance, common tumor sites, and lymphocytic infiltration findings aligned with previous studies. ERα expression was absent, while EGFR expression correlated with advanced tumor grade and metastasis, with a significant association to improved two-year disease-free survival.

Conclusion: This study shows that HNSCC is complex, and underlines the importance of EGFR for prognosis, emphasizing the need to consider molecular factors for personalized HNSCC treatment. The lack of ERα expression suggests more research are required.