Gasparotto Daniela, Maestro Roberta
Experimental Oncology 1, CRO-IRCCS, Aviano National Cancer Institute, I-33081 Aviano (PN), Italy.
Int J Oncol. 2007 Jul;31(1):175-80.
Despite the efforts during the last decades to improve clinical management and therapy, carcinomas of the head and neck still represent a disease with an unfavourable course. Over 50% of the patients die from their disease within 5 years after diagnosis, with tumour recurrence, metastasis, and development of second primary neoplasms as major causes of treatment failure. In addition, surgical treatment of locally advanced disease often results in invalidating and disfiguring conditions that heavily affect patients' quality of life. Current criteria of tumour staging, essentially based on clinical and pathological assessment, fail to prove effective in providing reliable information on tumour prognosis or supporting an optimized planning of the therapies, prompting the identification of new and more accurate staging criteria. This review focuses on the impact of molecular biology in HNSCC staging, namely differentiation of second primary lesions from recurrence/metastasis and detection of lymph node micrometastasis, and highlights how the integration of the histopathological diagnosis with molecular analyses may result in a better management of HNSCC patients.
尽管在过去几十年里人们努力改善临床管理和治疗，但头颈部癌仍然是一种病程不利的疾病。超过50%的患者在诊断后5年内死于该病，肿瘤复发、转移和第二原发性肿瘤的发生是治疗失败的主要原因。此外，局部晚期疾病的手术治疗常常导致功能丧失和毁容，严重影响患者的生活质量。目前的肿瘤分期标准主要基于临床和病理评估，在提供关于肿瘤预后的可靠信息或支持优化治疗方案方面未能证明有效，这促使人们寻找新的、更准确的分期标准。本综述重点关注分子生物学在头颈部鳞状细胞癌（HNSCC）分期中的影响，即区分第二原发性病变与复发/转移以及检测淋巴结微转移，并强调组织病理学诊断与分子分析的整合如何能够更好地管理HNSCC患者。
