Introduction

Systemic sclerosis (SSc) affects the connective tissue and leads to an abnormal fibrotic process in the skin and internal organs. Epidermal Growth Factor Receptor (EGFR) is able to induce cell proliferation and differentiation, and its expression is increased in SSc patients with pulmonary artery hypertension and in skin biopsies in patients with scleroderma. To date, no data on esophageal expression of EGFR are available in SSc patients. We aimed to evaluate whether the pro-fibrogenic pathways of SSc may affect EGFR expression in the esophagus.

Methods

A retrospective analysis included patients with SSc and control subjects suffering from gastroesophageal reflux symptoms. Endoscopic assessment and histopathologic analyses were performed in all subjects and the presence of microscopic esophagitis was used to distinguish patients with normal esophageal mucosa and subjects with non-erosive reflux disease. EGFR expression was measured in all subjects.

Results

A total of 35 patients with SSc were included, while the control group included 67 non-SSc patients. EGFR expression at the Z-line was higher in SSc patients than non-SSc patients in absence of microscopic esophagitis (median 65 %, IQR 56–71 % vs 42 %, IQR 37–54 %, p < 0.001). Microscopic esophagitis was found in 60 % of patients with SSc and 62.7 % of control patients, and EGFR expression was significantly higher in patients presenting microscopic esophagitis both in SSc and non-SSc patients.

Conclusion

The EGFR hyperexpression may be due to SSc and/or reflux-related damage in patients with microscopic esophagitis. Further studies are warranted to answer open questions and provide a possible role of EGFR in terms of diagnosis, prognosis, and therapy.

中文翻译：

---

表皮生长因子受体（EGFR）在系统性硬化症（SSc）和胃食管反流病（GORD）患者中的表达

介绍

系统性硬化症 (SSc) 会影响结缔组织并导致皮肤和内脏器官异常纤维化过程。表皮生长因子受体 (EGFR) 能够诱导细胞增殖和分化，其表达在患有肺动脉高压的 SSc 患者和硬皮病患者的皮肤活检中增加。迄今为止，尚无 SSc 患者食管 EGFR 表达的数据。我们的目的是评估 SSc 的促纤维化途径是否可能影响食管中 EGFR 的表达。

方法

一项回顾性分析包括 SSc 患者和患有胃食管反流症状的对照受试者。对所有受试者进行内窥镜评估和组织病理学分析，并使用显微镜下食管炎的存在来区分正常食管粘膜患者和非糜烂性反流病受试者。测量所有受试者的 EGFR 表达。

结果

总共包括 35 名 SSc 患者，对照组包括 67 名非 SSc 患者。在没有显微镜下食管炎的情况下，SSc 患者的 Z 线 EGFR 表达高于非 SSc 患者（中位数 65%，IQR 56-71% vs 42%，IQR 37-54%，p  < 0.001）。60% 的 SSc 患者和 62.7% 的对照患者发现显微镜下食管炎，并且在 SSc 和非 SSc 患者中出现显微镜下食管炎的患者中 EGFR 表达显着较高。

结论

EGFR 过度表达可能是由于显微镜下食管炎患者的 SSc 和/或反流相关损伤所致。需要进一步的研究来回答悬而未决的问题，并提供 EGFR 在诊断、预后和治疗方面的可能作用。