Muñoz-Guerra Mario Fernando, Marazuela Eva G, Martín-Villar Esther, Quintanilla Miguel, Gamallo Carlos
Department of Oral and Maxillofacial Surgery, Hospital de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
Cancer. 2004 Feb 1;100(3):553-60. doi: 10.1002/cncr.11933.
Clinicopathologic data demonstrated that the lymphatic system is the main route for solid tumor metastasis. However, the effect of intratumoral lymphangiogenesis (IL) on prognosis in oral carcinoma is still unknown because, until recently, no reliable markers for lymphatic endothelium were available. The current study analyzed the lymphatic vessels in tumor tissue specimens of patients with primary oral carcinoma using the new marker, PA2.26.
The authors investigated IL in surgical tissue samples of 61 patients with early-stage (Stages I-II) oral carcinoma. The tissue specimens were stained for PA2.26 and the correlation between IL and relevant parameters was analyzed by the Pearson chi-square test. In a univariate analysis using the Kaplan-Meier method, IL was analyzed against survival and disease-free period. Statistical significance of differences between distributions was studied by the log-rank test. Clinicopathologic parameters, including IL, were entered in a multivariate analysis to determine independent prognostic significance.
Thirty-three patients had IL. In the follow-up, a strong association was found between IL and locoregional recurrence (30.3 % of the patients with IL and 7.1% of the patients without IL). The presence of IL did not correlate significantly with the pT classification, primary location, or tumor differentiation. IL was found to have no influence on overall survival in univariate analysis, but there was significant association between IL and disease-free survival (P=0.03). Multivariate analysis revealed IL to be the sole independent factor influencing disease-free interval (P=0.02).
These results suggested that IL is associated with locoregional disease recurrence in early-stage oral carcinoma. The presence of IL was a useful discriminator in predicting the outcome of patients with absence of lymph node metastasis.
临床病理数据表明，淋巴系统是实体瘤转移的主要途径。然而，肿瘤内淋巴管生成（IL）对口腔癌预后的影响仍不清楚，因为直到最近，还没有可靠的淋巴管内皮标志物。本研究使用新的标志物PA2.26分析了原发性口腔癌患者肿瘤组织标本中的淋巴管。
作者调查了61例早期（I-II期）口腔癌患者手术组织样本中的IL。组织标本用PA2.26染色，并通过Pearson卡方检验分析IL与相关参数之间的相关性。在使用Kaplan-Meier方法进行的单因素分析中，分析了IL与生存率和无病期的关系。通过对数秩检验研究分布之间差异的统计学意义。将包括IL在内的临床病理参数纳入多因素分析，以确定独立的预后意义。
33例患者存在IL。在随访中，发现IL与局部区域复发之间存在密切关联（有IL的患者中为30.3%，无IL的患者中为7.1%）。IL的存在与pT分类、原发部位或肿瘤分化无显著相关性。在单因素分析中，IL对总生存率没有影响，但IL与无病生存率之间存在显著关联（P=0.03）。多因素分析显示IL是影响无病间期的唯一独立因素（P=0.02）。
这些结果表明，IL与早期口腔癌的局部区域疾病复发有关。IL的存在是预测无淋巴结转移患者预后的一个有用指标。
