BACKGROUND: Epidermal growth factor receptor (EGFR) activation plays a role in 
colorectal cancer (CRC) carcinogenesis, and anti-EGFR drugs are used in 
treatment of advanced CRC. One of the EGFR ligands is tumor-associated 
trypsinogen inhibitor TATI, also called serine protease inhibitor Kazal type1 
(SPINK 1), which we recently showed to be an independent prognostic marker in 
CRC.
METHODS: We studied the prognostic value of immunohistochemical expression of 
EGFR and concomitant expression of EGFR and TATI/SPINK1 in a series of 619 
colorectal cancer patients.
RESULTS: Of the samples, 92% were positive for EGFR. EGFR+/TATI+ was seen in 
62.8%, EGFR+/TATI- in 29.5%, EGFR-/TATI+ in 4.9%, and EGFR-/TATI- in 2.7% of 
patients. EGFR expression correlated with WHO grade (p = 0.040). In univariate 
analysis, EGFR expression correlated with favourable survival (p = 0.006). 
EGFR+/TATI+ patients showed better survival than did those with other 
combinations (p<0.001). In multivariate analysis, EGFR+/TATI+ was an independent 
prognostic factor of favourable prognosis (p<0.001).
CONCLUSION: Concomitant positivity of EGFR and TATI/SPINK1 predicts favourable 
prognosis in CRC.