Immunohistochemical staining with EGFR mutation-specific antibodies: high specificity as a diagnostic marker for lung adenocarcinoma

Mod Pathol. 2013 Sep;26(9):1197-203. doi: 10.1038/modpathol.2013.53. Epub 2013 Apr 19.

Abstract

We previously demonstrated a high specificity of immunohistochemistry using epidermal growth factor receptor (EGFR) mutation-specific antibodies in lung adenocarcinoma and correlation with EGFR mutation analysis. In this study, we assessed EGFR mutation status by immunohistochemistry in a variety of extrapulmonary malignancies, especially those that frequently show EGFR overexpression. Tissue microarrays containing triplicate cores of breast carcinomas (n=300), colorectal carcinomas (n=65), pancreatic adenocarcinoma (n=145), and uterine carcinosarcoma or malignant mixed müllerian tumors (n=25) were included in the study. Tissue microarray of lung adenocarcinoma with known EGFR mutation status was used as reference. Immunohistochemistry was performed using antibodies specific for the E746-A750del and L858R mutations. In pulmonary adenocarcinoma, a staining intensity of 2+ or 3+ correlates with mutation status and is therefore considered as positive. Out of 300 breast carcinomas, 293 (98%) scored 0, 5 (2%) had 1+ staining, 2 (1%) were 2+ for the L858R antibody. All breast carcinomas scored 0 with the E746-A750 antibody. All the colorectal, pancreatic carcinomas and malignant mixed müllerian tumors were negative (0) for both antibodies. Molecular analysis of the breast carcinomas that scored 2+ for L858R showed no mutation. Our results show that EGFR mutation-specific antibodies could be an additional tool distinguishing primary versus metastatic carcinomas in the lung. False-positivity can be seen in breast carcinoma but is extremely rare (1%).

MeSH terms

  • Adenocarcinoma / chemistry*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / secondary
  • Adenocarcinoma of Lung
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies*
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / genetics
  • Biopsy
  • Colorectal Neoplasms / chemistry
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • DNA Mutational Analysis
  • ErbB Receptors / analysis*
  • ErbB Receptors / genetics
  • False Positive Reactions
  • Female
  • Humans
  • Immunohistochemistry*
  • Lung Neoplasms / chemistry*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / secondary
  • Male
  • Middle Aged
  • Mixed Tumor, Mullerian / chemistry
  • Mixed Tumor, Mullerian / genetics
  • Mixed Tumor, Mullerian / pathology
  • Mutation*
  • Pancreatic Neoplasms / chemistry
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / pathology
  • Predictive Value of Tests
  • Prognosis
  • Tissue Array Analysis
  • Triple Negative Breast Neoplasms / chemistry
  • Triple Negative Breast Neoplasms / genetics
  • Triple Negative Breast Neoplasms / pathology
  • Uterine Neoplasms / chemistry
  • Uterine Neoplasms / genetics
  • Uterine Neoplasms / pathology

Substances

  • Antibodies
  • Biomarkers, Tumor
  • EGFR protein, human
  • ErbB Receptors