手术治疗喉鳞状细胞癌的预后影响因素

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。     

手术治疗喉鳞状细胞癌的预后影响因素

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.     

LCN2在喉鳞状细胞癌淋巴结转移中的表达及意义

摘 要：［目的］ 分析LCN2在喉鳞状细胞癌淋巴结转移表达及意义。［方法］ 收集咸宁市中心医院耳鼻咽喉科56例喉鳞状细胞癌患者标本,免疫组化方法分析淋巴结转移组和非转移组原发灶及淋巴结中LCN2的表达;组织芯片分析LCN2与分化程度的相关性。［结果］ LCN2蛋白在转移组喉鳞状细胞癌原发灶和淋巴结中的表达明显高于非转移组（P<0.05）。LCN2蛋白在高分化喉癌中呈低表达,在低分化喉癌中呈高表达,分化程度与LCN2蛋白表达明显相关（P<0.05）。［结论］ LCN2在伴淋巴转移的喉鳞状细胞癌中表达明显增高,可能成为预测淋巴结转移的分子标志物。     

Notch2在喉鳞状细胞癌中的表达及意义

目的 探讨Notch2在喉癌组织及体外培养的喉鳞癌细胞Hep-2中的表达及与喉癌患者临床病理资料之间的关系.方法 应用量子点超敏免疫荧光染色法检测95例喉癌组织标本中Notch2蛋白的表达,同时选取31例声带息肉标本作为对照组,结合患者临床病理资料进行分析;制作细胞爬片并进行量子点(QDs)免疫荧光染色检测Notch2蛋白在喉鳞癌细胞Hep-2中的表达.结果 95例喉癌组织中Notch2阳性表达率为92.6％ (88/95),其阳性率与声带息肉中的阳性率(32.3％)相比差异均有统计学意义(P＜0.01),其表达主要定位于细胞核.Notch2在喉癌组织中的表达与临床分期显著相关(P＜0.05):临床分期越高,表达率越高.Notch2在喉癌组织细胞核中表达阳性与T分级、临床分期、病理分级和淋巴结转移显著相关(P＜0.05).喉癌细胞Hep-2中Notch2表达阳性,其表达主要定位于细胞质和胞膜中.结论 Notch2在喉癌的发生发展中起着重要作用,其可能成为治疗喉癌的分子靶点.     

miR-221在110例喉鳞状细胞癌中的表达及其临床预后价值分析

摘 要：［目的］ 探讨微小RNA-221（microRNA-221,miR-221）在喉鳞状细胞癌（laryngeal squamous cell carcinoma,LSCC）组织中的表达水平及其与临床病理特征和预后的关系。［方法］ 收集110例LSCC患者的临床病理资料,应用实时荧光聚合酶链反应（real-time fluorescence PCR,RT-PCR）方法检测LSCC组织中miR-221的表达。应用ROC曲线确定miR-221在LSCC癌组织中相对表达量作为最佳截断值,分析miR-221高低表达与LSCC患者临床病理特征的关系。应用Kaplan-Meier和Log-rank生存分析法分析miR-221表达与LSCC患者预后的关系。Nomogram列线图评估LSCC患者术后1、3、5生存率。免疫组化方法检测LSCC患者肿瘤组织中PD-L1的表达,分析PD-L1与miR-221表达的关系。［结果］ miR-221表达与LSCC患者的年龄有关（P＜0.05）。生存分析显示,miR-221低表达患者预后较高表达患者好（DFS：χ2=10.380,P=0.001 3;OS：χ2=7.356,P=0.006 7）。单因素和多因素分析结果显示：肿瘤大小、淋巴结转移、miR-221表达是LSCC患者无病生存期和总生存期的独立预后因素。miR-221低表达伴PD-L1高表达的LSCC患者,相对其他组生存时间长、预后好。［结论］ miR-221在LSCC组织中高表达,与患者不良预后有关;miR-221低表达伴PD-L1高表达者预后更好。     

影响舌鳞状细胞癌患者预后的临床病理因素分析

目的：研究影响舌鳞状细胞癌患者预后的临床病理因素，方法：应用临床病理指标分析舌鳞状细胞癌患者预后的相关因素。结果：肿瘤分化程度，淋巴细胞浸润程度与区域淋巴结转移无关；肿瘤大小与区域淋巴结转移有关，肿瘤大小，淋巴细胞浸润程度与术后发生转移无关，分化程度与术后复发转移有关，结论：对于肿瘤直径大的舌鳞状细胞癌应积极采取病灶切除及颈淋巴结清扫术，肿瘤分化程度低者术后易出现复发转移。     

EB病毒基因在喉鳞状细胞癌中的表达

目的：ＥＢ病毒感染与喉鳞状细胞的发生发展是否有关迄今未明。本文目的在于了解ＥＢ病毒基因在喉鳞状细胞癌组织中的表达情况，探讨各种ＥＢ病毒基因产物在喉鳞状细胞癌发生发展中的生物学意义。方法：采用原位杂交和免疫组化技术，检测２９例不同分化类型喉鳞状细胞癌组织中ＥＢ病毒编码的小ＲＮＡ（ＥＢＥＲｓ）、潜伏感染膜蛋白（ＬＭＰ１）、ＥＢ病毒核抗原（ＥＢＮＡ－１）、溶解感染立即早期基因编码蛋白ＺＥＢＲＡ、早期基因编码蛋白ＥＡ－Ｄ、晚期基因编码蛋白ＶＣＡ和ＭＡ。结果：各检测指标在未分化癌、低分化和中分化鳞癌均有一定比例的阳性，但在２例高分化鳞癌均为阴性。发现ＥＢ病毒潜伏性和溶解性感染基因产物表达分别随着癌分化程度增高而减弱和增强。７例低分化和１例中分化鳞癌ＬＭＰ－１除胞膜和胞浆阳性外，胞核也呈明显阳性。２例低分化和１例中分化鳞癌中有少量癌细胞ＺＥＢＲＡ阳性。结论：部分喉鳞状细胞癌尤其是未分化和低分化鳞癌的发生发展与ＥＢ病毒感染密切相关，提示癌细胞的分化程度与ＥＢ病毒基因表达的差异有关。     

E2F3在喉鳞状细胞癌中的表达及临床意义

目的：探讨喉鳞癌中E2F3的表达与临床意义,为喉鳞癌的诊断、评估及治疗寻找辅助生物学指标。方法：采用免疫组化方法检测喉鳞癌组织及癌旁正常切缘组织中E2F3表达,结合喉鳞癌各临床参数,用SPSS16.0软件包进行统计分析E2F3表达情况与喉鳞癌各临床特征之间的关系。结果：E2F3在喉鳞癌与癌旁正常切缘中的阳性表达率分别为90.44%（123/136）和27.85%（22/79）,差异具有显著统计学意义（P〈0.001）;E2F3高表达与喉鳞癌患者年龄、临床分期及分型均相关（P〈0.05）。结论：E2F3核表达可能参与喉鳞癌发生发展过程;E2F3浆表达可能贯穿于喉鳞癌发生的整体过程。     

鳞癌抗原在喉鳞状细胞癌患者血清中的表达及意义

目的:通过鳞癌抗原(squamous cell carcinoma antigen,SCCAg)在喉鳞状细胞癌中的表达来评价其在喉癌诊断和预后中的意义。方法:采用微粒子酶免疫法(microparticle enzyme immunoassay,MEIA)检测46例喉鳞状细胞癌患者血清SCCAg的水平,以41例喉部良性疾病患者作为对照。结果:喉鳞状细胞癌患者与对照组的SCCAg值有明显差异(P<0.05),喉鳞状细胞癌组SCCAg阳性率为36.96%,良性病变组仅1例阳性,阳性率为2.44%。SCCAg阳性率与喉鳞状细胞癌TNM分期、淋巴结转移相关。复发患者SCCAg治疗1周后表达水平明显下降(P<0.05),但半年后又明显升高(P<0.05)。结论:SCCAg与喉鳞状细胞癌关系密切,有可能成为喉鳞状细胞癌的进展和预后的指标。     

喉鳞状细胞癌中p63基因蛋白表达及其意义

目的：探讨p63基因蛋白表达与喉鳞状细胞癌（laryngeal squamous cell carcinomas,LSCC）的发生、发展的关系和生物学意义。方法：应用免疫组织化学方法,检测30例LSCC、10例不典型增生和10例正常喉黏膜组织中p63基因蛋白的表达水平。结果：全部30例LSCC和10例不典型增生组织中p63染色均为阳性。LSCC分化程度越低,阳性细胞数越高、细胞的表达强度越高。正常喉黏膜组织中仅基底层及上基层细胞阳性。p63表达与LSCC分级和淋巴结转移相关（P〈0.05）。结论：p63可能参与了调控LSCC的发生、发展过程,其高表达预示LSCC预后不良。     

Prognostic Value of Ki67 and VEGF Expression in Laryngeal Squamous Cell Carcinoma

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.     

Prognostic value of PCNA and mutant p53 expression in laryngeal squamous cell carcinoma

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.     

Prognostic significance of cyclooxygenase-2 in laryngeal squamous cell carcinoma.

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.     

Prognostic value of VEGF expression in primary esophageal squamous cell carcinoma

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…     

Prognostic value of nuclear survivin expression in oesophageal squamous cell carcinoma

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.     

Prognostic value of body mass index before treatment for laryngeal squamous cell carcinoma

Objective

Patients with head and neck cancer often suffer from malnutrition. This study aims to investigate the influence of body mass index (BMI) on the prognosis of laryngeal squamous cell carcinoma (LSCC).

Methods

A total of 473 patients with LSCC initially treated at Sun Yat-sen University Cancer Center between January 2005 and July 2009 were retrospectively reviewed. Survival analysis was performed by the Kaplan-Meier method and Cox regression model.

Results

Low BMI before treatment was significantly associated with poor overall survival in patients with LSCC (P<0.001). BMI was an independent prognostic factor for patients with LSCC.

Conclusion

Leanness before treatment was associated with poor prognosis in patients with LSCC. Good nutritional status is favorable to improve survival in patients with LSCC.KEYWORDS : Prognosis, nutrition, body mass index (BMI), laryngeal squamous cell carcinoma (LSCC)     

Prognostic value of apoptosis-regulating protein expression in anal squamous cell carcinoma.

PURPOSE: This study evaluated the prognostic value of pro and antiapoptotic protein expression, as well as that of spontaneous apoptosis, in anal carcinoma patients treated by radiotherapy (RT) with or without chemotherapy. EXPERIMENTAL DESIGN: Ninety-eight patients with available pretreatment biopsy specimens were studied. Patients had been treated with split-course RT: 30-40 Gy fractionated external beam, followed by a 20-22-Gy boost using interstitial or external RT. Fifty-one patients also received concomitant mitomycin-C and 5-fluorouracil. Median follow-up for surviving patients was 124 months. Tissue sections were examined immunohistochemically for expression of proapoptotic proteins (Bax, p53), antiapoptotic proteins (Bcl-2, Mcl-1), and spontaneous apoptosis (M30). Except for M30, staining of less than 5% of tumor cells was considered negative. Protein expression was correlated with local tumor control (LC) and disease-free survival (DFS) outcomes. The Kaplan-Meier method was used for the monovariate analysis and the Cox proportional hazard models for the multivariate analysis. RESULTS: For LC, beside advanced T- and N-categories and longer overall treatment time (OTT), lack of Bcl-2 expression was associated with poorer 5-year outcome (62 versus 84%, P = 0.009). For DFS, advanced T- and N-categories, longer OTT, and the lack of Bcl-2 expression correlated significantly with lower rates. In the multivariate analysis, N-category (P = 0.0026), OTT (P = 0.04), Bcl-2 (P = 0.0015), and M30 (P = 0.035) expressions were significant factors for LC. For DFS, age (P = 0.049) an N-category (P < 0.0001), as well as expression of Bcl-2 (P = 0.001), p53 (P = 0.003), and M30 (P = 0.03), were found to be independent significant variables. Patients with Bcl-2(+)/p53(-) tumors had a significantly higher 5-year LC compared with patients whose tumors were Bcl-2(-)/p53(+) (93 versus 53%, P = 0.004). CONCLUSIONS: Bcl-2 and particularly the combination of p53 and Bcl-2 expression may prove to be useful predictors of tumor response to RT or radiochemotherapy in anal carcinomas. Patients having tumors that are Bcl-2(-) and p53(+) may require intensified radiochemotherapy or adoption of an alternative therapeutic approach.     

Prognostic value of c-erbB-2 protein expression in human lung adenocarcinoma and squamous cell carcinoma

203 primary human lung tumours, of which 119 were adenocarcinoma and 84 were squamous cell carcinoma, were investigated immunohistochemically for the expression of c-erbB-2 protein. Positive staining was evident in 33 (28%) of adenocarcinomas and 2 (2%) of squamous cell carcinomas. In cases of adenocarcinoma, c-erbB-2 was present in 18% of those with stage I disease. In stage IIIA, stage IIIB and stage IV cases, c-erbB-2 was present in 39%, 50% and 60%, respectively (I vs. IIIA and I vs. IIIB: P < 0.05, I vs. IV: P < 0.01). The 5-year survival rates of c-erbB-2 positive patients and those who were negative were 30% and 52%, respectively, with a statistically significant difference (P < 0.01). These observations suggest that when the expression of c-erbB-2 correlates with invasiveness of the tumour, this correlation may serve as a prognostic indicator, particularly in cases of adenocarcinoma of the lung.