免疫化疗与TIL得率及其杀瘤活性测定

通过收集经S－PVP免疫化疗及PVP化疗的口腔鳞癌原发灶内的肿瘤浸润淋巴细胞，计算其每克肿瘤组织中TIL得率；以Tca8113为靶细胞，测定TIL体外的杀癌活性。结果为S-PVP治疗者，每克肿瘤组织中TIL细胞数为7．5×105；PVP治疗者则为2．45×105；前者TIL的得率是后者的3倍。当放靶比为5:1时，S－PVP组TIL的杀后活性为38％，PVP组为32％，两者无显著性差异（P＞0.05）。结果提示，S－PVP方案治疗口腔鳞癌，除了化疗药物对肿瘤细胞的直接杀伤，还存在通过生物反应调节剂增加了TIL的数量而达到免疫抗癌作用。     

循环肿瘤细胞与口腔鳞状细胞癌相关性的研究进展

循环肿瘤细胞(CTCs)是从原发灶部位脱落、释放并转移到血液循环的肿瘤细胞,目前广泛应用于肺癌、乳腺癌等恶性肿瘤的早期诊断、治疗、疗效评价和预后判断,但是在口腔鳞状细胞癌(OSCC)中运用较少且缺乏相关的临床证据.有研究表明,CTCs是OSCC相对独立的预后指标,而且是复发或转移的重要原因之一.本文为深入阐述OSCC中...     

Margins and survival in oral cancer

In the surgical management of oral squamous cell carcinoma (SCC) we aim to resect the tumour with clear margins in all planes. The aim of this study was to identify and compare overall survival in a group of 591 patients who had resections, and to relate this to the clearance of margins at the tumour bed. We used life tables to calculate survival at one, two, three, five, and 10 years after diagnosis by margin (clear = 5 mm or more; close = 2–5 mm; and involved = less than 2 mm). Kaplan–Meier curves were produced for the margins alone, which were defined as clear in 480 patients (81%), close in 63 (11%), and involved in 48 (8%). Five-year survival was 81%, 75%, and 54% for clear, close, and involved margins, respectively, which highlights the importance of clear margins for survival. There is a significant prognostic implication associated with close, and particularly with involved, margins.     

Retropharyngeal lymph node metastasis in oral cancer. Systematic review and survival analysis

IntroductionMetastasis to retropharyngeal lymph nodes (RPLN) from oral squamous cell carcinoma is rare and associated with poor outcomes. The poor prognosis of RPLN is multifactorial and includes the clinicopathological aggressiveness of the primary disease and the late presentation. The aim of this systematic review is to assess the evidence on RPLN in patients diagnosed with oral squamous cell carcinoma (OSCC), the quality of the diagnostic modalities and the available treatment options. We aimed to analyse the overall survival of these patients diagnosed with RPLN.MethodsA systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. The initial literature search generated 289 articles. A total of 11 papers satisfied our criteria. Eight papers provided enough data to perform survival analysis and 3 papers compared the diagnostic modalities used in the detection of RPLN.ResultsA total of 73 OSCC patients diagnosed with RPLN metastasis were identified. The most common primary tumour subsites included the tongue (20), buccal mucosa (15) and gingiva (11). The cumulative 5-year OS rate was 17.8% while the 2-year overall survival was 35.9%.ConclusionThe presence of nodal metastasis is an independent prognostic factor in head and neck cancer. In this study, RPLN metastasis had a poorer prognosis (5 years overall survival is 17.8%) when compared to the survival rate of oral cancer without RPLN metastasis (5 years overall survival is 40%). There was no statistically significant difference between the overall survival in primary RPLN metastasis and recurrent RPLN disease.     

外周血嗜酸性粒细胞检测对口腔鳞状细胞癌术后的预后意义

目的探讨外周血嗜酸性粒细胞差异对口腔鳞状细胞癌术后患者的预后意义。方法回顾性分析2010年1月至2012年12月绍兴市人民医院口腔科住院并行手术治疗的口腔鳞状细胞癌患者62例,随访至2014年12月。计算嗜酸性粒细胞百分比及计数的均值,将患者分为大于等于均值组及小于均值组,比较两组患者术后的复发率,并将两组患者进行生存分析及多因素COX回归分析。结果按嗜酸性粒细胞计数均值分组,两组患者复发率及生存率差别均有统计学意义(P值分别为0.002和0.016)。按嗜酸性粒细胞百分比均值分组,两组患者复发率差异有统计学意义(P=0.005),生存率差异无统计学意义(P=0.253)。通过单因素生存分析,嗜酸性粒细胞计数是患者生存率的影响因素(P=0.030),多因素COX回归分析,嗜酸性粒细胞百分比与计数对生存率均无明显影响(P>0.05),而年龄及复发与否是患者生存率的影响因素(P<0.05)。结论口腔鳞状细胞癌术后早期患者外周血嗜酸性粒细胞百分比及计数减少提示该病复发的可能性大;尚无足够证据表明外周血嗜酸性粒细胞的改变将影响患者总体生存率。     

葡萄糖转运蛋白及其与口腔鳞状细胞癌的关系

葡萄糖转运蛋白(GLUT)是一组位于哺乳动物细胞膜上的非能量依赖性转运蛋白,是负责将葡萄糖向细胞内转运的主要载体。据报道,GLUT在多种恶性肿瘤组织中表达异常,且其表达与肿瘤的发生、发展及预后密切相关。GLUT有可能为口腔鳞状细胞癌的早期诊断及治疗提供一条新思路。本文就GLUT与口腔鳞状细胞癌的相关性研究进展作一综述。     

Invasive front grading: reliability and usefulness in the management of oral squamous cell carcinoma

BACKGROUND: The value of histological grading was examined with emphasis on reliability of assessment in 102 cases of intraoral squamous cell carcinoma from Northern Ireland with known outcome. METHODS: Two pathologists independently graded the invasive tumour front blinded to the stage and outcome. RESULTS: Intraobserver agreement was acceptable but interobserver agreement was not satisfactory. The degree of keratinisation was assessed most consistently while nuclear polymorphism was the least reliable feature. Multivariate survival analysis showed that the total grading score was associated with overall survival while the pattern of tumour invasion was the most valuable feature in estimating regional lymph node involvement. The number of positive lymph nodes was strongly associated with regional relapse, while the treatment modality and status of the surgical margins correlated with local relapse. CONCLUSIONS: Grading of selected features in OSCC is reliable and can facilitate treatment planning.     

p53 expression in oral precancer and cancer

Expression of the p53 tumour suppressor gene is a frequent finding in human malignancies, including oral cancer, and it has been detected in some potentially malignant lesions. The results of the present project showed that 35 of the 41 (85 per cent) oral mucosal lesions with histological evidence of epithelial dysplasia expressed p53, but the presence or absence of p53 staining could not be used to predict the outcome of potentially malignant oral mucosal lesions.     

免疫化疗对口腔鳞癌浸润T淋巴细胞及其亚群的影响

应用ABC免疫组化技术，检测口腔鳞癌患者接受免疫化疗（S－PVP）和单纯化疗（PVP）治疗前后肿瘤组织内CD3 、CD4 、CD3 和HLA－DR 细胞相对值，比较不同的诱导治疗方案对局部细胞免疫反应的影响．结果显示：S－PVP组治疗前后CD3 、CD4 、CD3 和HLA－DR 细胞分别为65．65、3660、35．93、54．04．和129．26、74．77、38．86、79．64。治疗后CD3 、CD4 细胞较治疗前明显增加（P＜0.05）．PVP组治疗前后CD3 、CD4 、CD3 和HLA－DR 细胞相对值无显著性差异．结果表明，S－PVP免疫化疗可使原发病杜内的T淋巴细胞数量增加，而单纯PVP化疗时局部细胞免疫反应的影响不甚明显。     

Expression of p16 in oral cancer and premalignant lesions

Background:  Expression of p16 has been proposed as a marker for malignant transformation. This study aimed to evaluate p16 expression in oral squamous cell carcinoma (OSCC) and premalignant lesions including oral leukoplakia (OL) with and without dysplasia.
Methods:  Expression of p16 was investigated in 56 samples including OSCC, OL with and without dysplasia, and normal oral mucosa. Expression of p16 was identified by immunohistochemistry, using the CINtecTM p16INK4a Histology Kit. Both nuclear and/or cytoplasmic staining of the keratinocytes were considered to be positive and the percentage of positive cells was calculated.
Results:  Expression of p16 was detected in 3/16 (18.75%) cases of OSCC, in 4/15 (26.7%) cases of OL without dysplasia, and in none of OL with dysplasia and normal mucosa. No significant differences in p16 expression prevalence were found among OSCC, OL with and without dysplasia and normal mucosa. The percentages of positive cells in OSCC and OL without dysplasia were 0.89 and 0.17, respectively. No significant difference in the percentage of positive keratinocytes was found.
Conclusion:  As a marker, p16 is not reliable for oral mucosal dysplasia and malignant transformation.     

血清SCC-Ag的变化对口腔鳞状细胞癌患者预后的影响

目的 研究血清鳞状细胞癌抗原(SCC-Ag)水平的变化对口腔鳞癌患者预后的影响。方法 采用ELISA检测了58例口腔鳞状细胞癌（鳞癌）患者手术前后血清SCC-Ag水平的改变。结果 术前及术后血清SCC-Ag值<1.5 μg/L的口腔鳞癌患者术后发生复发或转移发生率为15.6%和3.1%;术前和术后血清SCC-Ag水平>1.5 μg/L的口腔鳞癌患者术后发生复发或转移发生率为83.3%和95.5%;术前血清SCC-Ag水平>1.5 μg/L的口腔鳞癌患者术后血清SCC-Ag水平下降且SCC-Ag值<1.5 μg/L,其术后复发或转移发生率为25%。结论 血清SCC-Ag可能与口腔鳞癌的发生发展有关,其结果可作为判断患者病情的进展及肿瘤是否复发或转移。