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目的：研究表皮生长因子受体（epidermal growth factor receptor, EGFR）在晚期声门上型喉鳞癌组织中的表达情况及其与临床各相关因素的关系,探讨EGFR 能否作为判断晚期声门上喉鳞癌患者预后的预测性指标。方法：收集我院2004 年1 月～2008 年4 月共52 例晚期（III期、IV 期）声门上型喉鳞癌患者手术后切除的肿瘤组织，应用免疫组化技术检测EGFR表达情况，运用统计学方法，结合临床资料分析其与肿瘤分期、淋巴结转移、病理分化程度、生存率及术后放疗对预后的影响等临床病理特征的关系。结果：EGFR 在晚期声门上型喉鳞癌组织中存在阳性表达，阳性表达物质呈棕黄色，表达率为76.92 %（40/52），其中过表达率为 44.23 %。EGFR 的表达与晚期声门上型喉鳞癌患者的年龄、性别、吸烟无关，与浸润程度（P=0.005），淋巴结转移数目（P=0.018）， TNM分期(P=0.003)，病理分化程度（P=0.011）有关。单因素分析得出EGFR 表达程度、T、N 分期以及病理分化程度是影响无复发生存时间的危险因素（P<0.05），T、N 分期、病理分化程度是影响总生存时间的危险因素（P<0.05）。多因素分析显示只有肿瘤浸润程度（T分期）和淋巴结转移（N 分期）是影响无复发生存时间和总生存时间的独立预后因素。EGFR 的阴性表达组与阳性表达组的3 年、5 年生存率不具有统计学差异（P>0.05）。结论：EGFR 在晚期声门上型喉鳞癌组织中存在过表达，证实了EGFR 的过度表达与肿瘤的侵袭、转移相关，检测其表达水平对晚期喉癌的个体化治疗、靶向治疗有重要参考价值。但EGFR 尚不能作为晚期声门上型喉鳞癌行手术及术后辅助放疗患者对无复发生存时间和总生存时间的预测指标。

英文摘要:

Objective:To investigate the expression of EGFR in advanced supraglottic laryngeal squamous cell carcinoma,and its correlation with clinicopathologic parameters and prognosis.Methods:From Jan. 2004 to Apr. 2008, a total of 52 patients with advanced supraglottic laryngeal squamous cell carcinoma(stageIII, IV) received the surgical operation. The expression of EGFR in the tumor tissue was detected by immunohistochemistry. The statistical methods, combined with the clinical data were applied to analyze the relationship between expression of EGFR and pathological differentiation, tumor staging, lymph node metastasis, survival rate and the effect of postoperative radiotherapy.Results:This article confirmed the existence of EGFR overexpression in advanced supraglottic laryngeal squamous cell carcinoma. The positive-expressed substance was brown, and expression rate was 76.92%(40/52), and the rate of overpression was 44.23 %. The expression of EGFR had no relationship with the patient's age,sex,smoking status (P>0.05), but had significant correlation with the degree of infiltration (P=0.005), lymph node metastasis (P =0.018), and TNM staging (P=0.003), pathological differentiation (P = 0.011). In single factor analysis, the degree of the EGFR expression, T, N stage and pathological differentiation were independently associated with the relapse-free survival time (P <0.05). The status of T, N stage and pathological differentiation were both prognostic facors for the overall survival time (P <0.05). In multiple-factor analysis, only the degree of tumor infiltration (T stage) and lymph node metastasis (N stage) were independent prognostc factor of relapse-free survival and overall survival time. The negative expression and overexpression of EGFR didn't have significant differences in 3-year and 5-year survival rate (P> 0.05).Conclusion:This paper confirmed the overexpression of EGFR in advanced supraglottic laryngeal squamous carcinoma tissue. It had a great relationship with tumor's invasion and metastasis. To detect its expression level has an important reference value in individual therapy and target therapy of advanced supraglottic laryngeal squamous carcinoma. However, the EGFR could not yet be taken as a predictor of recurrence-free survival and overall survival time of the advanced supraglottic laryngeal squamous cell carcinoma patients who have surgery and postoperative radiotherapy.

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