Ahmed Wael A, Suzuki Kenji, Imaeda Yoshihiro, Horibe Yoshimune
Department of Otolaryngology, Second Hospital, Fujita Health University, School of Medicine, 3-6-10, Otobashi, Nakagawa Ku, Nagoya 454-8509, Japan.
Auris Nasus Larynx. 2008 Jun;35(2):213-9. doi: 10.1016/j.anl.2007.08.011. Epub 2007 Nov 8.
TNM staging system is not a sufficiently accurate method for predicting the response of an individual patient to a course of radiotherapy. After irradiation, it can become very difficult to assess data obtained by imaging and endoscopy for the diagnosis of both minimal persistent disease and early recurrence. The search for biological parameters that could be used to identify patients who will respond to radiotherapy is crucial. At this study we aimed at evaluating the prognostic significance of immunohistochemical expression of Ki-67, p53 and epidermal growth factor receptor (EGFR) in laryngeal glottic cancer involving the anterior commissure and treated with radiotherapy.
From January 1995 to August 2005, 24 patients with glottic cancer involving the anterior commissure were primary treated with radiotherapy. Six patients presented with T1a, 12 patients with T1b and 6 patients with T2. Biopsies were taken before the radiotherapy treatment started. Radiotherapy was done with the same technique for all patients using a linear accelerator device with beam energy of 4-MV photons. Immunohistochemical staining was performed using avidine-biotin-peroxidase technique with antibodies to Ki-67, p53 and EGFR.
p53 and EGFR positive expression values and labeling indices were greater in radioresistant than in radiosensitive tumors but without significant differences. On the other hand, Ki-67 was expressed in all radiosensitive tumors and Ki-67 labeling indices were significantly higher in radiosensitive tumors than radioresistant tumors (p=0.01).
We identified overexpression of Ki-67 as predictive marker of radiosensitivity in glottic cancer involving the anterior commissure, with the results showing significant difference between radiosensitive and radioresistant tumors.
TNM分期系统并非预测个体患者对放疗疗程反应的足够准确的方法。放疗后,评估通过成像和内镜检查获得的数据以诊断微小持续性疾病和早期复发变得非常困难。寻找可用于识别对放疗有反应的患者的生物学参数至关重要。在本研究中,我们旨在评估Ki-67、p53和表皮生长因子受体(EGFR)免疫组化表达在累及前联合的声门型喉癌放疗患者中的预后意义。
1995年1月至2005年8月,24例累及前联合的声门型喉癌患者接受了放疗作为初始治疗。6例为T1a期,12例为T1b期,6例为T2期。在放疗开始前进行活检。所有患者均使用束能量为4-MV光子的直线加速器设备,采用相同技术进行放疗。使用抗Ki-67、p53和EGFR抗体的抗生物素蛋白-生物素-过氧化物酶技术进行免疫组化染色。
p53和EGFR的阳性表达值及标记指数在放疗抗拒肿瘤中高于放疗敏感肿瘤,但无显著差异。另一方面,Ki-67在所有放疗敏感肿瘤中均有表达,且放疗敏感肿瘤中的Ki-67标记指数显著高于放疗抗拒肿瘤(p = 0.01)。
我们确定Ki-67过表达是累及前联合的声门型喉癌放疗敏感性的预测标志物,结果显示放疗敏感和放疗抗拒肿瘤之间存在显著差异。