de Aguiar Amanajás Francisco Carlos, Kowalski Luiz Paulo, de Almeida Oslei Paes
Department of Oral Pathology and Semiology, School of Dentistry of Piracicaba, University of Campinas, Av. Limeira 901, Cx. Postal 52, 13414-018 Piracicaba/SP, Brazil.
Oral Oncol. 2007 Jul;43(6):593-601. doi: 10.1016/j.oraloncology.2006.07.003. Epub 2006 Oct 25.
Early local recurrence is one of the main causes of treatment failure after definitive therapy of oral squamous cell carcinoma (OSCC), contributing significantly for the relative low survival rates of this neoplasia. The aim of this study was to investigate the clinical, histological and molecular factors involved in early local recurrence of OSCC, which may lead to better risk assessment in some specific cases. Twenty-seven patients with early recurrent OSCC were matched with 54 patients with the same clinical stage and tumor site but without local recurrence, in a pair-matched study design. All cases were evaluated in relation to the clinicopathological features and immunohistochemical expression of Ki-67, p53, bcl-2, FAS, Erb-B2, beta-catenin, and E-cadherin. The variables associated with ELR were alcohol consumption (p=0.019), treatment performed (p=0.041), and expression of Ki-67 (p=0.028), FAS (p=0.005) and membrane beta-catenin (p=0.026). The multivariate survival analysis (Cox regression) showed that surgery with adjuvant radiotherapy [OR=0.26 (95% CI, 0.1-0.6)] and FAS expression [OR=0.21 (95% CI, 0.1-0.5)] had a significant effect for ELR development. Radiotherapy had no significant impact on patients' overall survival. Therefore, both treatment and molecular characteristics of the tumor seem to be involved in early local recurrence.
早期局部复发是口腔鳞状细胞癌（OSCC）根治性治疗后治疗失败的主要原因之一，对该肿瘤相对较低的生存率有显著影响。本研究的目的是调查OSCC早期局部复发所涉及的临床、组织学和分子因素，这可能有助于在某些特定病例中进行更好的风险评估。在一项配对研究设计中，将27例早期复发性OSCC患者与54例临床分期和肿瘤部位相同但无局部复发的患者进行配对。对所有病例的临床病理特征以及Ki-67、p53、bcl-2、FAS、Erb-B2、β-连环蛋白和E-钙黏蛋白的免疫组化表达进行评估。与早期局部复发相关的变量包括饮酒（p=0.019）、所进行的治疗（p=0.041）以及Ki-67（p=0.028）、FAS（p=0.005）和膜β-连环蛋白（p=0.026）的表达。多因素生存分析（Cox回归）显示，辅助放疗的手术[比值比（OR）=0.26（95%可信区间，0.1 - 0.6）]和FAS表达[OR=0.21（95%可信区间，0.1 - 0.5）]对早期局部复发的发生有显著影响。放疗对患者的总生存期没有显著影响。因此，治疗和肿瘤的分子特征似乎都与早期局部复发有关。
