Sakurai Kazunari, Urade Masahiro, Noguchi Kazuma, Hashitani Susumu, Takaoka Kazuki, Segawa Emi, Kishimoto Hiromitsu
Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Head Neck. 2007 Nov;29(11):1002-9. doi: 10.1002/hed.20627.
Despite recent advances in the diagnosis and treatment of oral carcinoma, outcomes remain disappointing. The identification of new prognostic factors is necessary to improve survival. To determine the prognostic significance of cyclooxygenase (COX)-2 and DNA topoisomerase (DNA-Topo) IIalpha expression in patients with oral carcinoma, we immunohistochemically examined these enzymes and studied their relation to overall 5-year survival.
Surgical specimens were obtained from 160 patients with oral carcinoma, 80 with and 80 without regional lymph node metastasis. The specimens were immunostained for COX-2 and DNA-Topo IIalpha as an index of cell proliferative activity. COX-2 immunoreactivity and clinicopathological data were analyzed, and 5-year survival was calculated by the Kaplan-Meier method.
COX-2 expression in primary lesions was higher in cases with lymph node metastasis than in those without lymph node metastasis. An increase in tumor size was associated with increased COX-2 expression. In most cases with lymph node metastasis, COX-2 expression was higher in metastatic lesions than in primary lesions. As COX-2 expression increased, the DNA-Topo IIalpha labeling index significantly increased and the overall 5-year survival rate decreased.
Expression of COX-2 and DNA-Topo IIalpha were related to lymph node metastasis, cell proliferative activity, and overall 5-year survival rate in oral carcinoma. These enzymes may therefore be valuable diagnostic and prognostic indices in oral carcinoma.
尽管口腔癌的诊断和治疗最近取得了进展，但治疗结果仍然令人失望。确定新的预后因素对于提高生存率至关重要。为了确定环氧化酶（COX）-2和DNA拓扑异构酶（DNA-Topo）IIα表达在口腔癌患者中的预后意义，我们采用免疫组织化学方法检测了这些酶，并研究了它们与总体5年生存率的关系。
从160例口腔癌患者中获取手术标本，其中80例有区域淋巴结转移，80例无区域淋巴结转移。以COX-2和DNA-Topo IIα作为细胞增殖活性指标对标本进行免疫染色。分析COX-2免疫反应性和临床病理数据，并采用Kaplan-Meier法计算5年生存率。
有淋巴结转移的病例原发灶中COX-2表达高于无淋巴结转移的病例。肿瘤大小增加与COX-2表达增加相关。在大多数有淋巴结转移的病例中，转移灶中COX-2表达高于原发灶。随着COX-2表达增加，DNA-Topo IIα标记指数显著增加，总体5年生存率降低。
COX-2和DNA-Topo IIα的表达与口腔癌的淋巴结转移、细胞增殖活性和总体5年生存率相关。因此，这些酶可能是口腔癌中有价值的诊断和预后指标。
