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1.
刘玉东  甄娟  韩晓丽 《中国肿瘤临床》2018,45(22):1129-1132
  目的  观察E3泛素连接酶SIAH2在喉鳞状细胞癌组织中的表达, 探讨其在喉鳞状细胞癌中表达的预后价值。  方法  应用免疫组织化学染色法检测119例喉组织标本SIAH2的定性表达, Western blot方法检测喉新鲜组织中SIAH2的定量表达, 结合患者5年随访资料, 利用Kaplan-Meier法绘制生存曲线, Log-rank法分析SIAH2的表达水平与喉鳞状细胞癌患者预后的关系, Cox比例风险回归模型分析喉鳞状细胞癌患者预后的独立预测因素。  结果  SIAH2在喉鳞状细胞癌中阳性表达率为77.19%, 显著高于不典型增生(53.13%)和癌旁正常喉组织(26.67%), 差异具有统计学意义(χ2=21.02, P<0.001)。SIAH2的表达与组织学分级、临床分期及淋巴结转移相关(均P<0.05);在正常喉组织(1.25±0.04)、不典型增生(1.38±0.05)及喉鳞状细胞癌组织(1.44±0.07)中SIAH2的相对表达量逐渐升高(F=61.811, P<0.001);SIAH2阳性与阴性患者的5年生存率分别为18.18%和58.33%(χ2=5.720, P= 0.017), SIAH2阳性与阴性患者的中位生存时间分别为25个月和60个月(P<0.05);多因素回归分析表明高表达SIAH2是喉鳞状细胞癌患者总生存期的独立预测因子。  结论  SIAH2可能作为一个癌基因参与喉鳞状细胞癌的发生发展, 过表达SIAH2与喉鳞状细胞癌患者的不良预后有关, 提示SIAH2作为一个潜在的靶基因可能对喉鳞状细胞癌的治疗有帮助。   相似文献   

2.
OBJECTIVE To investigate the prognostic value of measuring Ki67 and VEGF expression in laryngeal squamous cell carcinoma (LSCC). METHODS The expression of Ki67 and VEGF in 32 LSCC tissues was studied by immunohistochemical staining. Of these cases, 5 recurred (recurrent group), 3 cases metastasized (metastatic group), 8 cases died (deceased group) and 24 cased survived (survival group) over a 3 year period of follow-up after their operation. RESULTS The expression of Ki67 and VEGF in the deceased group was higher compared to that in the survival group (P〈0.01). Overexpression of Ki67 was found in the recurrent group and in the metastatic group (P〈0.05). VEGF expression was higher in the recurrent group than in the non recurrent group (P〈0.05). With Cox-regression of multivariate analysis, Ki67 (RR:3.236; P=0.001), the clinical T stage (RR:1.382; P=0.029) and metastasis in lymph nodes (RR:0.316; P=0.033) were shown to be independent prognostic factors for survival of LSCC patients. CONCLUSION Ki67 and VEGF expression is related to the prognosis of LSCC. Overexpression of the 2 markers indicated poor prognosis of the disease, a finding which might be helpful for the treatment of laryngocarcinoma.  相似文献   

3.
The objective of this study was to investigate the prognostic significance of p53, and proliferative cell nuclear antigen (PCNA) in laryngeal squamous cell carcinoma (LSCC). Sixty pathologic specimens from the patients with LSCC were examined for the expression of the p53 and PCNA, with complete follow-up data. Sixty-three percent of the cases displayed nuclear p53 overexpression. There was a correlation between p53 overexpression and histological grades (p = 0.03), and localization site (p = 0.05). Median of PCNA index was 42.2 (range 5.9 to 85.2). There was no difference between the p53 overexpression group and the normal group in proliferative activity determined by PCNA (p = 0.73). In univariate analyses, localization site, grade, stage, invasion pattern, lymph node status, were significant factors in estimating disease free survival (DFS). Grade was the most important factor affecting recurrence (p = 0.002). In multivariate analyses, grade was the only significant predictor for DFS (p = 0.001). Grade (p = 0.001) and invasion pattern (p = 0.03) were found to be significant predictors of overall survival. In conclusion, the histological grade was the most reliable important prognostic factor. Further studies are necessary to facilitate understanding of the mechanisms of laryngeal carcinogenesis.  相似文献   

4.
目的:分析手术治疗喉鳞状细胞癌的预后影响因素.方法:收集本院2002年1月-2005年12月期间手术治疗的101例喉鳞状细胞癌患者临床及随访资料,选取11个可能的预后影响因素,通过单因素和Cox比例风险回归模型分析,评价喉癌预后的影响因素.结果:手术治疗喉癌患者的3年生存率为76.09%;单因素分析结果显示声带活动度,临床分型,T分期,淋巴结转移及肿瘤分化程度对3年生存率的影响有统计学意义(P<0.05);Cox比例风险回归模型分析示声带活动度,肿瘤T分期,及有无淋巴结转移是预后的独立影响因素(P<0.05).结论:声带活动度,肿瘤T分期以及有无淋巴结转移是手术治疗喉鳞状细胞癌预后的独立影响因素,对于治疗方案的确定和预后判断具有重要价值.  相似文献   

5.
目的:分析手术治疗喉鳞状细胞癌的预后影响因素。方法:收集本院2002年1月-2005年12月期间手术治疗的101例喉鳞状细胞癌患者I隘床及随访资料,选取11个可能的预后影响因素,通过单因素和Cox比例风险回归模型分析,评价喉癌预后的影响因素。结果:手术治疗喉癌患者的3年生存率为76.09%;单因素分析结果显示声带活动度,临床分型,T分期,淋巴结转移及肿瘤分化程度对3年生存率的影响有统计学意义(P〈0.05);Cox比例风险回归模型分析示声带活动度,肿瘤T分期,及有无淋巴结转移是预后的独立影响因素(P〈0.05)。结论:声带活动度,肿瘤T分期以及有无淋巴结转移是手术治疗喉鳞状细胞癌预后的独立影响因素,对于治疗方案的确定和预后判断具有重要价值。  相似文献   

6.
目的 探讨术前白蛋白与球蛋白比值(albumin/globulin ratio,AGR)对喉鳞状细胞癌患者预后的评估价值。 方法 回顾性分析2008年1月至2017年12月于广西医科大学附属肿瘤医院头颈外科行喉癌手术治疗的147例患者的临床资料。通过X-Tile软件计算AGR的最佳截断值,并根据最佳截断值分为高AGR组(AGR>1.31,n=98)和低AGR组(AGR≤1.31,n=49),比较两组患者的临床病理特征及总生存期。结果 两组患者肿瘤部位分型、T分期、N分期、临床分期差异均有统计学意义(P<0.05);高AGR组3年、5年总生存率分别为88.5%、82.4%,低AGR组分别为70.1%、56.4%,生存曲线比较差异有统计学意义(χ2=16.639,P<0.001)。单因素Cox回归显示,吸烟、肿瘤部位分型、组织学分级、T分期、N分期、临床分期、AGR与患者总生存期有关(P<0.05);校正潜在的混杂因素后,多因素Cox回归显示AGR≤1.31是影响患者总生存期的独立危险因素(HR=2.098,95%CI:1.142~3.856,P=0.017)。结论 低AGR的喉鳞状细胞癌患者预后较差,AGR可作为预后评估的指标。  相似文献   

7.
Squamous cell carcinoma of the larynx is a major public health concern; it causes substantial morbidity and mortality, and arises chiefly as a result of tobacco and alcohol consumption. Early stage disease is best treated with radiation or surgery alone, but for patients with more locally advanced squamous cell carcinoma of the larynx, combined modality treatment has been shown to benefit selected patients, particularly when cisplatin-based chemotherapy and concurrent radiation therapy are employed, with or without altered fractionated radiation therapy. Substantial laryngectomy-associated quality-of-life decrements can be avoided in selected, potentially resectable patients with organ-sparing approaches, without sacrificing survival. Recently, trials have addressed the role of targeted systemic agents to the epidermal growth factor receptor, and other targets are under investigation. The addition of induction chemotherapy to concurrent chemoradiotherapy is a promising treatment strategy that warrants further evaluation, but has not yet emerged as a standard of care; the toxicity of such regimens must be balanced with the potential benefits on a case-by-case basis, and functional outcomes are often quite variable. Treatment planning, management and follow-up are complex, and thus should ideally be performed in a comprehensive, multidisciplinary fashion, in a center accustomed to a high volume of such cases. Future research directions are described herein.  相似文献   

8.
Epidermal growth factor receptor (EGFR) overexpression is an unfavorable prognostic marker in laryngeal squamous cell carcinoma (SCC). EGFR stimulates cyclooxygenase-2 (COX-2) expression in normal human keratinocytes and squamous carcinoma cells. Based on these observations a prognostic role of COX-2 expression in laryngeal SCC can be hypothesized. Consequently, COX-2 expression was studied in laryngeal SCC (median follow-up = 47 months; range: 2-87 months) by quantitative immunohistochemistry (n = 61) and EGFR by binding assay (n = 51). Well-differentiated regions of laryngeal SCC revealed strong COX-2 immunostaining, whereas histologically normal areas neighboring tumor as well as poorly-differentiated tumors were negative. Immunohistochemical results were confirmed by Western blot analyses. Cox's regression analysis showed that the combination of low levels of COX-2 integrated density and high levels of EGFR covariates provided strong prediction, at 5-year follow-up, of both poor overall survival (chi(2) = 12.905; p = 0.0016) and relapse-free survival (chi(2) = 9.209; p = 0.01). In vitro studies on CO-K3 cell line, obtained from an EGFR positive, COX-2 negative poorly-differentiated laryngeal SCC, revealed that EGF stimulation failed to induce COX-2 expression and PGE2 production suggesting a change in EGFR signaling pathway. These findings indicate that COX-2 is overexpressed in less aggressive, low grade laryngeal SCC, whereas its expression is lost when tumors progress to a more malignant phenotype.  相似文献   

9.
We assayed methyl-p-hydroxyphenyllactate esterase (MeHPLAase) activity in 63 cases of primary laryngeal squamous cell carcinoma. MeHPLAase activity did not show any correlation with oestrogen, progesterone and epidermal growth factor (EGF) receptor levels. No significant relationship was found between MeHPLAase activity and age, sex, tumour site, T classification, stage of disease and EGFR status, whereas a significant inverse relationship was found between enzymatic activity and neck lymph node positivity at presentation. The median value of MeHPLAase activity tended to be higher in tumours with low histopathological grade than in those with high histopathological grade. During the follow-up period (median 50 months, range 2-90 months) locoregional recurrences were observed in 31 out of 63 (49%) cases. At the end of the study, 27 out of 63 (43%) patients had died of cancer. Cox univariate analysis using MeHPLAase activity as a continuous covariate showed that the levels of enzymatic activity were inversely associated with the risk of death and relapse. Assuming the mean value of enzymatic activity as the cut-off value, we found a statistically significant relationship between high MeHPLAase activity and longer relapse-free and overall survival. MeHPLAase activity status retained its prognostic significance also in the lymph node-negative subgroup of patients. On multivariate analysis, both EGFR and MeHPLAase activity proved to be independent factors for predicting a short relapse and the overall survival.  相似文献   

10.
目的:探讨细胞凋亡与VI腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)预后之间的关系。方法:48例患者均接受过外科切除手术治疗并被分成2组:24例接受新辅助化疗及另外的24例仅接受外科手术治疗。通过TUNEL法,评价经福尔马林固定、石蜡包埋预处理的48例OSCC标本的细胞凋亡水平,并且将TUNEL法标记的凋亡细胞百分比表示为细胞凋亡指数(apoptotic index,AI)。结果:在仅接受外科手术治疗的患者组,高AI与好的预后显著相关(P〈0.05)。结论:结合其它附加信息,如肿瘤分级、治疗方法,AI值可以作为OSCC患者的一个可靠的预后因子。  相似文献   

11.

Purpose

Anal cancer is an uncommon malignancy, but its incidence is increasing worldwide. Chemoradiation is the standard primary treatment for patients with loco-regional limited disease. However, once patients develop metastatic spread, the prognosis is very poor. Human papillomavirus (HPV) is present in around 80 % of anal cancers, but its prognostic and/or predictive value is essentially unknown in this disease.

Methods

We retrospectively evaluated 50 patients with the diagnosis of anal squamous cell carcinoma treated at our institution with combined chemoradiotherapy for loco-regional limited disease. HPV status was evaluated from paraffin-embedded tumor tissues collected at the time of diagnosis by a polymerase chain reaction analysis.

Results

Among 50 patients, 42 (84 %) were HPV-positive. Thirty-two (64 %) patients were positive to genotype 16, two (4 %) to genotype 18, and three (6 %) to both 16 and 18. Lymph nodal involvement and clinical stage at diagnosis were more advanced for HPV-positive patients. After a median follow-up of 4 years (range 0.4–13.8), 46 (92 %) patients were alive. Overall, eight patients relapsed: One regional, one loco-regional, and six distant recurrences were observed. Four patients died of metastatic disease. Five-year disease-free survival (DFS) in HPV-positive and HPV-negative patients was 92.5 and 50.0 %, respectively (P < 0.01). In multivariate analysis, HPV-positivity was associated with a statistically significant better 5-year DFS (HR HPV+ vs HPV? 0.10; 95 % CI 0.02–0.50). Five-year overall survival in HPV-positive and HPV-negative patients was 93.3 and 66.7 %, respectively (P = 0.12).

Conclusions

In our study, HPV-positive anal cancers had a statistically significant improved DFS compared to HPV-negative group.  相似文献   

12.
To clarify the synergistic influence of human papillomavirus (HPV) status and squamous cell carcinoma antigen (SCCA) mRNA expression on head and neck squamous cell carcinoma (HNSCC) prognosis, HPV DNA presence and SCCA1 and SCCA2 mRNA expression were determined by PCR and quantitative real‐time RT‐PCR, respectively, in 121 patients with primary HNSCC who were receiving curative treatment. HPV DNA was detected in 28.1% (34/121) of HNSCC cases, and only high‐risk types (HPV‐16, HPV‐33, HPV‐35 and HPV‐58) were observed. Positive HPV status showed a significantly better prognosis than negative HPV status (P = 0.022). An elevated SCCA2/SCCA1 mRNA ratio was an independent predictor of disease recurrence (P = 0.004). In addition, HPV‐negative patients with a high SCCA2/SCCA1 ratio (>0.27) had a significantly lower recurrence‐free survival rate than HPV‐negative patients with a low SCCA2/SCCA1 ratio (P 0.011). Our findings revealed that both HPV status and the SCCA2/SCCA1 mRNA ratio are independently associated with prognosis in HNSCC. Patients with both a HPV‐negative status and a high SCCA2/SCCA1 ratio might need intensified treatment and rigorous follow up after treatment because of the high risk of recurrence.  相似文献   

13.
Prognostic value of body mass index in locally advanced breast cancer.   总被引:1,自引:0,他引:1  
PURPOSE: The purpose of this retrospective study was to determine the association and prognostic value of body mass index (BMI) at the time of initial diagnosis in patients with locally advanced breast cancer (LABC). The analysis includes the subsets of inflammatory (IBC) and noninflammatory (non-IBC LABC) breast cancer. EXPERIMENTAL DESIGN: We identified 602 patients who had LABC treated on prospective clinical trials. BMI was divided into three groups: (a) < or =24.9 (normal/underweight), (b) 25.0 to 29.9 (overweight), and (c) > or =30 (obese). Kaplan-Meier product limit method was used to estimate survival outcomes. Cox proportional hazards were used to determine associations between survival and BMI and to test for an interaction between BMI and breast cancer type. RESULTS: Eighty-two percent had non-IBC LABC and 18% had IBC. Obese patients tended to have a higher incidence of IBC compared with overweight and normal/underweight groups (P = 0.01). Median follow up was 6 years for all patients. Median overall survival (OS) and recurrence-free survival (RFS) were 8.8 and 5.9 years, respectively. Patients with LABC who were obese or overweight had a significantly worse OS and RFS (P = 0.001) and a higher incidence of visceral recurrence compared with normal/underweight patients. In a multivariable model, BMI remained significantly associated with both OS and RFS for the entire cohort. The interactions between BMI and LABC subsets and between BMI and menopausal status were not statistically significant. CONCLUSION: Patients with LABC and high BMI have a worse prognosis. Evaluation of the biological factors associated with this observation can provide tools for additional therapeutic interventions.  相似文献   

14.
Epidermal growth factor receptor (EGFR) content was determined by a radioligand receptor assay in 140 primary laryngeal squamous cell carcinomas (median value of 8.4 fmol mg-1 protein, range 0-169.9 fmol mg-1 protein). Cox univariate regression analysis using EGFR as a continuous variable showed that EGFR levels are directly associated with the risk of death (chi 2 = 14.56, P-value = 0.0001) and relapse (chi 2 = 7.77, P-value = 0.0053). A significant relationship between EGFR status and survival was observed at the different arbitrary cut-off values chosen (8, 16 and 20 fmol mg-1 protein). The cut-off value of 20 fmol mg-1 protein was the best prognostic discriminator. In fact, the 5 year survival was 81% for patients with EGFR- tumours compared with 25% for patients with EGFR+ tumours (P < 0.0001). The 5 year relapse-free survival was 77% for patients with EGFR- tumours compared with 24% for patients with EGFR+ tumours (P < 0.010). When clinicopathological parameters and EGFR status were examined in the multivariate analysis, T classification and EGFR status retained an independent prognostic value. In this study we demonstrated that high EGFR levels single out patients with poor prognosis in laryngeal cancer.  相似文献   

15.
目的 舌鳞状细胞癌(tongue squamous cell carcinoma,TSCC)是最常见的头颈部肿瘤之一,其生长较局限,早期易发生淋巴结转移.本研究探讨术前外周血中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)对TSCC患者预后的评估价值.方法 回顾性分析广州医科大学附属肿瘤医院2011-01-01-2014-12-31行根治性手术治疗的56例TSCC患者临床资料,根据患者术前外周血NLR分为低NLR组(NLR≤1.94,28例)和高NLR组(NLR>1.94,28例),分析两组患者NLR与临床病理因素之间的关系,比较两组患者的总生存率(overall survival,OS)和无瘤生存率(disease-free survival,DFS).结果 NLR升高与患者年龄、性别、不良嗜好、肿瘤生长部位、临床分期、复发无显著相关(P>0.05),而与肿瘤分化程度(P=0.003)、淋巴结转移(P=0.035)密切相关;低NLR组患者的1、3、5年OS分别为96.4%、85.7%和85.7%,高NLR组分别为78.6%、57.1%和53.6%;两组5年DFS分别为82.1%和39.3%,差异有统计学意义,P<0.05.单因素回归分析显示,肿瘤中低分化、肿瘤临床分期(Ⅲ~Ⅳ期)、复发和术前NLR(NLR>1.94)与患者OS、DFS相关,是患者预后不良的影响因素;多因素Cox回归分析显示,肿瘤中低分化、肿瘤临床分期(Ⅲ~Ⅳ期)、复发术前NLR(NLR> 1.94)是影响患者总生存期的独立预后因素.结论 术前高NLR(NLR> 1.94)是影响TSCC患者预后的独立危险因素,术前NLR升高提示TSCC患者预后不良.  相似文献   

16.
Human oral cancer has a high risk of locoregional relapse which is difficult to diagnose early due to lack of prognostic markers. We and others have shown aberrant expression of cytokeratin (CK) 8 and 18 in human oral cancer. Aberrant supra-basal expression of CK19 has been shown earlier. In this study, our aim was to develop a non-invasive test for prognostication of human oral cancer. Immunoradiometric assay (IRMA) was used to measure the circulating levels of TPA in the sera of 80 oral cancer patients before surgery and seven days after surgery. Elevated serum TPA levels were noted in the post surgery samples of 28 out of the 50 patients for whom clinical follow-up was available, as compared to their pre-surgery samples. TPA levels in the pre-surgery serum samples of patients were significantly higher than levels in the sera of healthy controls (p=0.001). Elevated levels in patients correlated significantly with stage (p=0.02), development of recurrence (p<0.006), and impacted survival (p<0.033). IHC analysis showed statistically significant correlation between expression of CK8, 18 and 19 in surrounding uninvolved tissues of the tumour and post surgery elevated serum TPA levels (p<0.001). This suggests the possibility that CK fragments are released from the surrounding uninvolved tissues into the sera of patients after surgical removal of the tumour. Thus, our study indicates that TPA can be a useful tumour marker for the prediction of recurrence and poor prognosis in human oral cancer.  相似文献   

17.
Both the morbidity and mortality of esophagus cancer are very high in China. The modern treatment for this disease is surgery plus adjuvant multi-therapies, mainly including chemotherapy and radiotherapy. The postoperative 5-year survival rate, unfortunately, is still low. It is around 30% in China and 10% in the west. More and more evidences have demonstrated that there is a close relationship between treatment effect and bio-behavior of esophagus cancer. To search for better prognostic ind…  相似文献   

18.
Squamous cell carcinoma antigen (SCC Ag) was estimated in 30 controls, in 16 patients with benign lesions of the uterine cervix, and in 51 patients with uterine cervical carcinoma. The rate of positivity of the antigen among the cancer patients was 87% (N = 49). SCC Ag estimations were of no diagnostic value, since 37% of patients with benign lesions had elevated levels compared to controls. SCC Ag was highly correlated to histologic subtype. The highest values were obtained in keratinizing tumors, followed by large cell nonkeratinizing and small cell nonkeratinizing types. Moreover, elevation of SCC Ag was statistically significant (p less than 0.001) among all the three histologic subtypes compared to controls. However, SCC Ag levels were not consistently correlated to the stage of the disease. Patients with pretherapeutic SCC Ag levels above 30 ng/ml had a faster recurrence rate and shorter survival than those who exhibited antigen values below 2.0 ng/ml. From our results, it is suggested that SCC Ag has limited use as a parameter for early diagnosis of cervical carcinoma, but it seems to reflect advancement of the disease. These findings indicate that SCC Ag elevation may prove to be a valuable marker in predicting subclinical disease.  相似文献   

19.
Survivin, a new member of the family of apoptosis inhibitors, is expressed almost exclusively in proliferating cells, above all in cancers. Subcellular localisation and prognostic implications of the survivin protein have not yet been determined in oesophageal squamous cell carcinoma. The survival of 84 patients with oesophageal squamous cell carcinomas was correlated with the extent of immunohistochemical survivin expression in tumour cell nuclei. Tumours were scored positive when >5% cells stained positive. Patients were followed up for at least 5 years or until death. In normal oesophageal squamous cell epithelium, some cytoplasmic survivin expression was detected in the basal cells, whereas proliferating cells showed nuclear staining of survivin. Nuclear expression of survivin was also detected in 67 cancers (80%). The mean survival for patients of this group (28 months, range 20-36) was significantly less than that for patients without survivin expression in the tumour cell nuclei (108 months, range 62-154, P=0.003). Using univariate analysis, nuclear survivin expression (P=0.003), tumour depth (P=0.001), lymph node metastasis (P=0.003) and stage (P<0.001) were the best predictors of survival. In contrast, cytoplasmic survivin staining was noted in 53 (63%) tumours and had no prognostic relevance. In conclusion, the analysis of nuclear survivin expression identifies subgroups in oesophageal squamous cell cancer with favourable (survivin(-)) or with poor prognosis (survivin(+)). We suggest that the determination of nuclear survivin expression could be used to individualise therapeutic strategies in oesophageal squamous cell cancer in the future.  相似文献   

20.

Background:

An increased body mass index (BMI) is significantly associated with favourable prognosis in renal cell carcinoma (RCC). This study investigated the associations among sex, BMI, and prognosis in clear cell RCC patients.

Methods:

We retrospectively analysed 435 patients with clear cell RCC who underwent a nephrectomy. The associations among sex, BMI, clinicopathologic factors, and cancer-specific survival (CSS) were analysed.

Results:

As a continuous variable, increased BMI was associated with higher CSS rate by univariate analysis in the whole population (hazard ratio, 0.888 per kg m–2; 95% confidence interval, 0.803–0.982; P=0.021). A sub-population analysis by sex demonstrated that BMI was significantly associated with CSS in men (P=0.004) but not in women (P=0.725). Multivariate analysis revealed BMI to be an independent predictor of CSS in only men.

Conclusion:

Body mass index was significantly associated with clear cell RCC prognosis. However, the clinical value of BMI may be different between men and women.  相似文献   

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