Eriksen Jesper Grau, Overgaard Jens
Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark.
Radiother Oncol. 2007 Jun;83(3):383-8. doi: 10.1016/j.radonc.2007.05.009. Epub 2007 May 31.
CA IX is suggested to be an endogenous marker of hypoxia in tumours like squamous cell carcinomas of the head and neck (HNSCC). The aim of the present study was to investigate whether CA IX served as a prognostic factor for outcome in a large population of HNSCC and if CA IX was able to discriminate the tumours that did benefit from hypoxic modification with nimorazole.
Paraffin-embedded formalin-fixed pre-treatment tumour tissue was available from 320 of the 414 patients treated in the randomized DAHANCA 5 protocol with primary radiotherapy+/-the hypoxic radiosensitizer nimorazole. CA IX was measured using immunohistochemistry and results were divided into four groups of CA IX expression: <1%, 1-10%, 10-30% and >30% of the tumour area with positive membrane staining. Locoregional control and disease-specific survival were used as endpoints.
Expression of CA IX was not correlated to any of the tumour or patient characteristics investigated. Furthermore, CA IX did not serve as a prognostic marker in the total cohort as well as in the group of 150 patients treated without nimorazole. Finally, no relation was found between the different expression levels of CA IX and the influence of nimorazole when locoregional control or disease-specific survival was used as endpoints.
This is to date one of the largest studies of CA IX in HNSCC. The data suggest that CA IX have no prognostic or predictive potential in patients with cancer in the head and neck treated with conventional radiotherapy and concomitant nimorazole.
碳酸酐酶IX（CA IX）被认为是头颈部鳞状细胞癌（HNSCC）等肿瘤缺氧的内源性标志物。本研究的目的是调查CA IX是否可作为大量HNSCC患者预后的预测因素，以及CA IX是否能够区分那些确实从尼莫唑缺氧修饰中获益的肿瘤。
在随机DAHANCA 5方案中接受原发放疗±缺氧放射增敏剂尼莫唑治疗的414例患者中，有320例患者可获得福尔马林固定石蜡包埋的治疗前肿瘤组织。采用免疫组织化学法检测CA IX，结果分为CA IX表达的四组：肿瘤面积阳性膜染色<1%、1-10%、10-30%和>30%。局部区域控制和疾病特异性生存作为研究终点。
CA IX的表达与所研究的任何肿瘤或患者特征均无相关性。此外，CA IX在整个队列以及未接受尼莫唑治疗的150例患者组中均未作为预后标志物。最后，以局部区域控制或疾病特异性生存作为终点时，未发现CA IX的不同表达水平与尼莫唑的影响之间存在关联。
这是迄今为止关于HNSCC中CA IX的最大规模研究之一。数据表明，CA IX在接受常规放疗和联合尼莫唑治疗的头颈部癌症患者中没有预后或预测潜力。
