Prognostic value of lymph node involvement in oral squamous cell carcinoma

Clinical Oral Investigations - Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and...     

Prognostic value of hypercalcaemia and leucocytosis in resected oral squamous cell carcinoma

Hypercalcaemia and leucocytosis are common in our patients with progressive oral squamous cell carcinoma (SCC). However, the precise incidence, prognostic value, and correlation with the condition of the tumour remain obscure. A total of 618 patients with oral SCC who were treated primarily between 2007 and 2012 and had serum calcium concentrations and white blood cell count (WCC) measured postoperatively were included in the study. Primary TNM stage, pathological features, and the presence of locoregional recurrence or distant metastasis after comprehensive surgical treatment were recorded. The incidence of hypercalcaemia was 9.1% and that of leucocytosis 7.2%. Hypercalcaemia correlated significantly with size of primary tumour (T status), nodal involvement (N status), TNM stage, perineural invasion, lymphovascular permeation, and recurrence or metastasis of disease. Leucocytosis, however, correlated only with T status, lymphovascular permeation, and recurrence or metastasis. In multivariate analysis of survival, recurrence, metastasis, hypercalcaemia, and leucocytosis were strong independent prognostic factors. Median survival was low if the patient had hypercalcaemia or leucocytosis (179 (range 3–73) days if the patient had distant metastasis, and 43 (range 3–102) days if the patient had locoregional recurrence). The incidence of hypercalcaemia and leucocytosis was high during the course of the disease, and both conditions have an adverse impact on survival from oral SCC. Periodic evaluation of serum calcium concentrations and WCC should be routine during the postoperative period.     

血清MIR4435-2HG在口腔鳞状细胞癌中的预后价值分析

目的探讨血清MIR4435-2HG水平在口腔鳞状细胞癌诊断和预后中的价值。方法本研究为回顾性病例对照研究。纳入癌症和肿瘤基因图谱(the cancer genome atlas project,TCGA)数据库中头颈部鳞状细胞癌的口腔鳞状细胞癌患者518个样本,以长链非编码RNA MIR4435-2HG表达量中位数为界,将患者分为高表达组和低表达组,比较两组患者的5年无病生存率和总生存率。收集2012年1月至2015年1月就诊于湖州师范学院附属口腔医院口腔颌面外科的82例口腔鳞状细胞癌患者的血清标本进行验证,探索MIR4435-2HG的预后价值。通过生物信息学手段预测MIR4435-2HG参与的生物学过程。运用SPSS 23.0设定MIR4435-2HG的最佳诊断和预后截点。结果分析TCGA数据库中518个口腔鳞状细胞癌患者样本显示,MIR4435-2HG高表达组患者的5年总生存率[43.2%(112/259)]显著低于MIR4435-2HG低表达组[51.7%(134/259)](P<0.05);MIR4435-2HG高表达组的5年无病生存率[56.8%(147/259)]显著低于MIR4435-2HG低表达组[64.1%(166/259)](P<0.05)。82例口腔鳞状细胞癌患者样本验证结果显示,MIR4435-2HG高表达组的3年总生存率[40.0%(8/20)]显著低于MIR4435-2HG低表达组[80.6%(50/62)](P<0.05)。对血清MIR4435-2HG高表达组和血清MIR4435-2HG低表达组患者的临床病理资料进行比较,结果显示两组患者的性别、年龄、肿瘤发生部位、TNM分期差异均无统计学意义(P>0.05)。MIR4435-2HG高表达组的淋巴结转移率[45.0%(9/20)]显著高于低表达组[12.9%(8/62)](P<0.05),且高表达组的组织学分级[80.0%(16/20)]显著高于低表达组[24.2%(15/62)](χ2=20.030,P<0.05)。生物信息学分析结果显示,MIR4435-2HG靶基因的生物功能主要富集于蛋白质代谢、核仁和胞质中rRNA的加工、SEMA4D诱导细胞迁移过程、线粒体翻译启动及伸长过程等。结论血清MIR4435-2HG可作为口腔鳞状细胞癌的潜在预后标志物。     

P33ING1在口腔鳞状细胞癌中的表达及意义

目的:研究P33ING1蛋白表达与口腔鳞状细胞癌发生发展的关系。方法:应用免疫组化检测2004～2006年收治的30例口腔鳞状细胞癌组织中的P33ING1表达情况。结果:口腔鳞状细胞癌中P33ING1蛋白表达阳性率为40%(12/30),明显低于对照组的100%(15/15),两者比较差异有显著性(χ2=10.272,P<0.05)。结论:P33ING1蛋白在口腔鳞状细胞癌组织中的表达下降,提示P33ING1蛋白可能在口腔鳞癌的发生发展中有重要意义。     

Maspin expression in oral squamous cell carcinoma

Maspin (mammary serine protease inhibitor) is a member of the serpin superfamily of protease inhibitors and it has a role as a tumor suppressor. Maspin has been reported to be important in processes relevant to tumor growth and metastasis such as cell invasion, angiogenesis, and apoptosis. A high expression of maspin was correlated with better rates of survival and absence of nodal metastases in head and neck squamous cell carcinoma. In contrast, some studies have shown that maspin overexpression is correlated with a poor prognosis in pancreatic and ovarian cancers and in lung adenocarcinoma. The aim of this study was an immunohistochemical evaluation of the maspin expression in oral squamous cell carcinoma and thus 89 patients were evaluated. Maspin expression in oral squamous cell carcinoma was significantly associated with the tumor differentiation grade (chi test: P = 0.0318) and the lymph node status (chi test: P < 0.005), but not with the tumor stage (chi test: P = 0.666). Metastatic involvement of lymph nodes was observed more frequently in maspin-negative cases than in tumors with more than 5% of positive cells (P = 0.0024). The present results confirm that maspin expression predicts a better prognosis in oral squamous cell carcinoma and that maspin probably plays a role in tumor progression.     

透明质酸在口腔鳞状细胞癌组织中的表达

目的 本研究旨在探讨透明质酸在不同分化口腔鳞状细胞癌中的表达及意义.方法 应用免疫组织化学法检测37例不同分化程度口腔鳞状细胞癌组织中透明质酸的表达.结果 按阴性(-)、弱阳性( )、阳性( )、强阳性( )表示,并进行统计学分析.结果 透明质酸主要表达于肿瘤间质和细胞外基质,细胞膜和胞浆中染色相对较少.37例口腔鳞状细胞癌组织中,低分化鳞癌透明质酸的表达明显高于高分化鳞癌(P＜0.05),表达随肿瘤分化程度降低而增强.结论 透明质酸的表达与口腔鳞状细胞癌的分化程度有关,分化越低,其表达越强.透明质酸的高表达可能有利于病变的侵袭和转移.     

Prognostic value of lymph node count from selective neck dissection in oral squamous cell carcinoma

Unlike the levels of anatomical exploration, there is no consensus on the extent of lymph node dissection, or lymph node count (LNC), during selective neck dissection (SND). The aim of this study was to validate the prognostic impact of LNC on survival and to determine an optimal LNC cut-off value for SND. A retrospective investigation identified 78 patients with a diagnosis of oral squamous cell carcinoma (OSCC) who underwent SND (levels I–III or levels I–IV). LNC and clinicopathological variables were analyzed for any association with survival in Cox proportional hazards models. Based on the receiver operating characteristic curve, a cut-off value of 19 lymph nodes was found to predict overall survival (OS) (area under the curve 0.732, sensitivity 67.8%, specificity 75.0%; P = 0.026) and disease-specific survival (DSS) (area under the curve 0.762, sensitivity 68.1%, specificity 77.8%; P = 0.011). On Cox regression, LNC (≥19 vs. <19) was the only independent predictor of OS (hazard ratio 5.29, 95% confidence interval 1.39–20.05; P = 0.014) and DSS (hazard ratio 6.76, 95% confidence interval 1.40–32.77; P = 0.018). Similar results were obtained in the pathologically lymph node-negative subgroup (n = 66). Based on the study findings, SND should include 19 or more lymph nodes for a survival benefit.     

Prognostic significance of immunohistochemical biomarkers in oral squamous cell carcinoma

Advances in understanding of the molecular mechanisms underlying oral squamous cell carcinoma (OSCC) have resulted in an increasing number of biomarkers that can be used to predict the behaviour of this disease. The authors conducted a literature review of studies examining the role of immunohistochemistry-based protein biomarkers in predicting OSCC outcome. Only articles published in PubMed-indexed journals over the past 5 years were considered. 22 molecular biomarkers were identified and classified into five groups based on their biological functions: cell cycle acceleration and proliferation; tumour suppression and apoptosis; hypoxia; angiogenesis; and cell adhesion and matrix degradation. The cell cycle acceleration and proliferation biomarkers showed the most divergent prognostic findings. Studies on tumour suppression and apoptosis biomarkers were the most prevalent. There were only a few studies examining molecular biomarkers of hypoxia and angiogenesis, and studies examining cell adhesion and matrix degradation biomarkers have shown that this group has the greatest potential for assessing prognostic parameters. Amongst the several proteins analysed, the immunohistochemical expression levels of epithelial growth factor receptor (EGFR), p53, and matrix metalloproteinases (MMPs) have demonstrated the greatest potential for survival prediction in OSCC, but this review demonstrates that their prognostic relevance is debatable and requires further standardisation.     

膜联蛋白A1表达下降在口腔鳞癌中的意义

目的：研究膜联蛋白A1（ANXA1）在口腔鳞癌中的表达及其与临床病理的关系。方法：应用实时定量PCR、Western印迹方法和免疫组化方法检测ANXA1在口腔鳞癌细胞株和30例原发口腔鳞癌中的表达，采用SPSS10．0软件包对数据进行非参数检验。结果：与人永生化口腔黏膜上皮细胞（HIOEC）相比，Tca8113、TSCC、OSC和NT细胞中ANXA1的mRNA表达降低；Tca8113、TSCC、CAL-27、OSC和NT细胞中ANXA1的蛋白表达降低。30例口腔鳞癌组织标本中，ANXA1的mRNA和蛋白表达均较癌旁组织降低（p〈0．001）。ANXA1的表达水平与肿瘤的病理分化程度有关（mRNA：P=0．007；蛋白：P=0．006），与肿瘤大小、临床分期、淋巴结转移无关。结论：ANXA1在口腔鳞癌中表达降低，可能与肿瘤的发生、发展和组织分化有关。     

口腔鳞癌首诊患者血清Cyfra 21-1检测的预后评价价值

目的探讨在口腔鳞癌首诊患者中检测血清Cyfra 21-1含量的预后价值.方法收集56例正常人和107例口腔鳞癌首诊患者的治疗前血清样本,采用ELISA方法检测血清中Cyfra 21-1的含量,跟踪随访12～57个月,采用SPSS10.0统计软件包进行相关分析.结果口腔鳞癌首诊患者治疗前血清Cyfra 21-1含量为(1.14±1.19)μg/L,显著高于对照组的(0.40±0.16)μg/L(P=0.001);其检测敏感度和特异度分别为55.1%和96.4%.结合跟踪随访,肿瘤复发和死亡的患者,治疗前血清Cyfra 21-1含量显著高于肿瘤不复发(P=0.026)和存活(P=0.001)的患者,血清Cyfra 21-1含量越高,患者生存率越低,生存时间越短(P=0.003).结论口腔鳞癌患者血清Cyfra 21-1含量显著升高,并且与预后相关.检测血清Cyfra 21-1含量对口腔鳞癌患者具有一定的临床应用价值.     

cyclin D1蛋白表达预测头颈鳞癌预后

目的:探讨cyclin D1蛋白表达在判断头颈鳞癌患者预后方面的意义.方法:选取头颈鳞癌患者96例,取肿瘤标本制作组织芯片,应用免疫组化方法检测cyclin D1蛋白的表达情况.蛋白表达与临床病理学参数的关系应用非参数检验(Kruskal-Wallis检验),与预后的关系应用Kaplan-Meier检验和Cox回归多因素生存分析,所有统计学分析均采用SPSS17.0软件包完成.结果:患者平均随访时间为6.2a.Kaplan-Meier生存分析表明,cyclin D1低表达与高表达患者相比预后更好(P=0.009);多因素生存分析表明,cyclin D1蛋白表达是唯一与总生存率密切相关的因子(HR:2.260,95％ CI:1.074-4.758;P=0.032).该蛋白表达与病理分级、临床分期、性别及发病部位等临床病理学参数无关.结论:cyclin D1表达是预测头颈鳞癌患者预后的独立因子,能够作为头颈鳞癌潜在的分子诊断和靶向治疗靶点.     

CD44在口腔鳞癌中的表达

目的初步探讨CD44分子在口腔鳞癌中的表达情况。方法以免疫组织化学方法对22例口腔不同部位的鳞癌及其周边扩大切除的组织进行了观察研究,并和癌组织的病理分级进行对比分析。结果 CD44表达在正常口腔粘膜表皮的基底细胞和部分棘层细胞的细胞膜上,同时在淋巴细胞上强表达。在鳞癌上皮组织中CD44的表达模式发生紊乱,表达水平与细胞分化程度有关,病理分化度较差的癌组织中CD44的表达逐渐减弱。结论 CD44可以作为评价口腔鳞癌恶性度的一个指标。     

表皮生长因子受体在口腔鳞状细胞癌中的表达及临床意义

目的：探讨表皮生长因子受体在口腔鳞状细胞癌中的表达及其与临床的关系，材料和方法，手术切除４０例口腔鳞状细胞癌组织标志，经用表皮生长因子受体单克隆抗体和免疫组织化学方法进行观察，分析其表达特点及临床表现，结果：表皮生长因子受体表达与患者的性别，年龄，发病部位，ＴＮＭ分期和淋巴细胞结转移无关（Ｐ〉０．０５）。高分化鳞状细胞癌的表达低于低分化（Ｐ〈０．０１），结论：表皮生长因子肥体表达状况与口腔鳞状细胞