喉癌肿瘤标志物和喉癌分子切缘及临床因素与喉癌复发的相关性研究

目的:从喉癌肿瘤标志物、喉癌分子切缘以及临床因素三个方面分析喉癌复发的相关因素.方法:应用免疫组织化学方法检测喉癌复发组与未复发组原发灶、喉癌外科切缘的CyclinD1、p27、p53以及eIF4E表达状况,通过回顾性分析103例喉癌的临床资料,探讨喉癌复发的临床因素;并综合三方面因素对喉癌复发进行多因素分析.结果:喉癌术后复发组与未复发组原发灶的CyclinD1、p27、p53表达差异均有统计学意义(均P<0.05),eIF4E表达差异无统计学意义(P>0.05).两组切缘的CyclinD1、p27、p53、eIF4E表达差异均有统计学意义(均P<0.05),喉癌复发组eIF4E切缘阳性表达率高于CyclinD1、p27和p53.喉癌术后复发与原发肿瘤部位、T分期、淋巴结转移、喉癌病理分化程度以及首次手术方式有关;与年龄、性别、是否术后放疗无关.Logitic多因素回归分析显示:喉癌术后复发与肿瘤T分期、淋巴结转移、喉癌病理分化程度以及首次手术方式有关.综合肿瘤标志物、喉癌分子切缘以及临床因素三个方面的Logistic多因素回归分析显示:喉癌术后复发与喉癌T分期、颈部淋巴结转移、病理分化程度以及分子切缘阳性有关.结论:影响喉癌术后复发的因素复杂多样;喉癌T分期高、有颈部淋巴结转移、病理分化程度差以及分子切缘阳性者术后容易复发;喉癌分子切缘阳性是更为敏感的喉癌复发因素.

Relative factors analysis including carcinoma marker, molecular margin and clinical factors on laryngeal eaeinoma recurrence

Objective:To investigate the factors of laryngeal carcinoma recurrence,103 patients of laryngeal carcinoma were analyzed retrospectively on carcinoma marker,molecular margin and clinical factors with univariate analysis and multivariate analysis.Method:CyclinD1,p27,p53 and eIF4E in primary site and surgery margins were detected in laryngeal carcinoma recurrence group and unrecurrence group with immunohistochemical staining to explore the significance of CyclinD1,p27,p53 and eIF4E on laryngeal carcinoma recurrence;The clinical data of 103 patients of laryngeal carcinoma were analyzed retrospectively to investigate the clinical factors of laryngeal carcinoma recurrence;At last above three factors were analyzed with multivariate analysis.Result:There was significant difference between laryngeal carcinoma recurrence group and unrecurrence group about CyclinD1,p27 and p53 in laryngeal primary site;There was no significant difference between laryngeal carcinoma recurrence group and unrecurrence group about eIF4E.There was significant difference between laryngeal carcinoma recurrence group and unrecurrence group about CyclinD1,p27,p53 and eIF4E in surgery margins.Laryngeal carcinoma recurrence after surgery was related with carcinoma site,T stage,node metastasis,laryngeal carcinoma pathology and operative methord;However,it was not related with age,sex and postoperative irradiation therapy with univariate analysis.Laryngeal carcinoma recurrence after surgery was related with T stage,node metastasis,laryngeal carcinoma pathology and operative methord with logistic multivariate analysis.At last,laryngeal carcinoma recurrence after surgery was related with T stage,node metastasis,laryngeal carcinoma pathology and positive molecular margins with logistic multivariate analysis.Conclusion:The factors of laryngeal carcinoma recurrence is comprehensive.T stage,node metastasis,laryngeal carcinoma pathology and laryngeal carcinoma positive molecular margins were related with laryngeal carcinoma recurrence.Positive molecular margins were more reliable.