Combination of EGFR, HER-2/neu, and HER-3 is a stronger predictor for the outcome of oral squamous cell carcinoma than any individual family members

In a series of 111 patients with squamous cell carcinoma (SCC), we used imm unohistochemistry to examine the expression levels of four epidermal growth factor receptor (EGFR) family members (EGFR, HER-2/neu, HER-3, and HER-4). Expression of the EGFR members was not significantly associated with tumor size, However, their expressions (except for HER-4) were significantly ass ociated with the presence of lymph node metastasis, and all of them were si gnificantly associated with distant metastasis, We further examined the ass ociation between the expression levels of the EGFR members and the survival rates in 47 oral SCC patients whose detailed clinical follow-ups were avai lable, The expression of all EGFR members was significantly associated with shortened patient survival, and the association was strongest for HER-2/ne u, Furthermore, the combination of HER-2, HER-3, and EGFR but not HER-4 sig nificantly improved the predicting power. The expression level of HER-2/neu was significantly correlated with that of EGFR or HER-3, Similar coexpress ion patterns were also observed in three oral SCC cell lines studied, but n ot in four other head and neck SCC cell lines. Taken together, these result s indicated that expression levels of EGFR, HER-2/neu, and HER-3 may help p redict the outcome of patients with oral SCC.