Bouda J, Boudova L, Hes O, Havir M, Tempfer C, Kohlberger P, Svoboda T, Rokyta Z, Speiser P
Department of Obstetrics and Gynecology, Medical Faculty Hospital, Charles University, Plzen, Czech Republic.
Anticancer Res. 2005 Jan-Feb;25(1B):617-22.
The aim of our study was to clarify whether CD44v6 evaluation can serve as a universally applicable prognostic factor in patients with FIGO stage IB cervical carcinoma. A retrospective study was performed on 178 FIGO stage IB (142 IB N0, 36 IB N1) radically operated cervical carcinoma patients. The expression of CD44v6 was investigated by immunohistochemistry (IHC). The prognostic significance of established prognostic factors and CD44v6 expression was analyzed by univariate and multivariate analyses. To test the reproducibility and to account for interobserver variability, all specimens were evaluated independently at two institutions. Two different IHC scoring systems, several cut-off levels for CD44v6 positivity and several statistical methods for IHC results evaluation were used. In a univariate analysis, the most significant prognostic factor for overall survival (OS) was lymph node status (p<0.001) followed by tumor volume, LVSI, GOG score (p<0.01) and a deep stromal invasion (p = 0.06). We found a strong correlation between CD44v6 expression and squamous cell carcinoma (SCC) (SCC vs. adenocarcinoma - p<0.001) and between CD44v6 expression and deep stromal invasion, LVSI and GOG score (p<0.05). The CD44v6 expression was not a statistically significant prognostic factor for OS in a univariate analysis (p=0.39 Vienna; p=0.54 Freiburg). In a multivariate analysis, the most significant prognostic factor for OS was lymph node status (p =0.002), followed by tumor diameter and LVSI (p<0.05). CD44v6 expression was not a statistically significant prognostic factor for OS or disease-free interval (DFI) independent of the scoring method used. In conclusion, we demonstrated that CD44v6 expression is associated with LVSI, deep stromal invasion and SCC, but has no prognostic influence on OS and DFI in a population of 178 women with FIGO stage IB cervical carcinoma.
我们研究的目的是阐明CD44v6评估能否作为国际妇产科联盟（FIGO）IB期宫颈癌患者普遍适用的预后因素。对178例接受根治性手术的FIGO IB期（142例IB N0，36例IB N1）宫颈癌患者进行了一项回顾性研究。通过免疫组织化学（IHC）研究CD44v6的表达。通过单因素和多因素分析来分析既定预后因素和CD44v6表达的预后意义。为了测试可重复性并考虑观察者间的变异性，所有标本均在两个机构进行独立评估。使用了两种不同的IHC评分系统、几种CD44v6阳性的临界值水平以及几种IHC结果评估的统计方法。在单因素分析中，总生存期（OS）最显著的预后因素是淋巴结状态（p<0.001），其次是肿瘤体积、淋巴血管间隙浸润（LVSI）、妇科肿瘤学组（GOG）评分（p<0.01）和深部间质浸润（p = 0.06）。我们发现CD44v6表达与鳞状细胞癌（SCC）之间存在强相关性（SCC与腺癌相比 - p<0.001），并且CD44v6表达与深部间质浸润、LVSI和GOG评分之间也存在强相关性（p<0.05）。在单因素分析中，CD44v6表达对OS不是一个具有统计学意义的预后因素（维也纳p=0.39；弗莱堡p=0.54）。在多因素分析中，OS最显著的预后因素是淋巴结状态（p =0.002），其次是肿瘤直径和LVSI（p<0.05）。无论使用何种评分方法，CD44v6表达对OS或无病生存期（DFI）都不是一个具有统计学意义的预后因素。总之，我们证明了在178例FIGO IB期宫颈癌女性患者中，CD44v6表达与LVSI、深部间质浸润和SCC相关，但对OS和DFI没有预后影响。
