Department of Medical and Surgical Specialties, Otolaryngology Section, University of Padova, Padova, Italy.
Histopathology. 2011 Jun;58(7):1148-56. doi: 10.1111/j.1365-2559.2011.03864.x.
The mammalian target of rapamycin (mTOR) has a key role in regulating cancer cell proliferation, apoptosis, cell migration, and angiogenesis. The aim of this study was to assess the relationships between mTOR and clinicopathological and prognostic parameters in laryngeal squamous cell carcinoma (SCC).
Mammalian target of rapamycin expression was determined in 103 consecutive operable laryngeal SCCs. Among the mTOR-positive cases, the locoregional recurrence rate was higher (P=0.048) and the disease-free survival (DFS) rate was shorter (P=0.031) in patients with mTOR expression >50.7%. In the N(0) subgroup, the disease recurrence rate was higher (P=0.034) and the DFS was shorter (P=0.009) in patients with mTOR expression >50.7%. In mTOR-positive patients, multivariate analysis showed that N stage (P=0.0001) and mTOR status (P=0.042) were independent indicators of a poor prognosis.
mTOR appeared to be a significant predictor of DFS in univariate and multivariate models. mTOR expression in laryngeal SCC may be useful for the detection of patients at higher risk for recurrence, and N(0) patients at higher risk for early locoregional recurrence who might benefit from more aggressive therapy. The role of mTOR inhibitors in multimodality or multitarget strategies against laryngeal SCC warrants investigation.
哺乳动物雷帕霉素靶蛋白(mTOR)在调节癌细胞增殖、凋亡、细胞迁移和血管生成方面具有关键作用。本研究旨在评估 mTOR 与喉鳞状细胞癌(SCC)临床病理和预后参数之间的关系。
对 103 例可手术的喉 SCC 连续病例进行了 mTOR 表达测定。在 mTOR 阳性病例中,mTOR 表达>50.7%的患者局部区域复发率较高(P=0.048),无病生存率(DFS)较短(P=0.031)。在 N(0)亚组中,mTOR 表达>50.7%的患者疾病复发率较高(P=0.034),DFS 较短(P=0.009)。在 mTOR 阳性患者中,多变量分析显示 N 分期(P=0.0001)和 mTOR 状态(P=0.042)是预后不良的独立指标。
mTOR 在单变量和多变量模型中似乎是 DFS 的重要预测指标。mTOR 在喉 SCC 中的表达可能有助于检测复发风险较高的患者,以及 N(0)患者局部区域复发风险较高,可能受益于更积极的治疗。mTOR 抑制剂在多模态或多靶点策略治疗喉 SCC 中的作用值得进一步研究。