Riou G F, Bourhis J, Le M G
Laboratoire de Pharmacologie Clinique et Moléculaire, Institut Gustave Roussy, Villejuif, France.
Anticancer Res. 1990 Sep-Oct;10(5A):1225-31.
The biological behavior of early-stage invasive carcinoma of the uterine cervix is not always predictable. Therefore it is important to identify new biological markers which could more accurately predict the evolution of the disease. Amplification and/or overexpression of the c-myc gene were frequently observed in advanced-stage cervical cancers and were shown to be associated with tumor progression. More interesting was the study on 93 patients with early-stage carcinoma showing that c-myc gene overexpression was significantly related to a higher risk of relapse. A combination of c-myc expression and nodal status provided a very accurate indication of the risk of relapse. Indeed, in the subgroup of patients with negative nodes, the 3-year disease-free survival rate was 93% (95% confidence interval CI: 79-98%) when c-myc was expressed at a normal level, whereas this rate was only 51% (95% CI: 26-63%) when c-myc was overexpressed. Moreover the c-myc overexpression was related to a 6.1-times higher risk of distant metastases, suggesting that activation of this proto-oncogene may lead to metastatic ability of tumor cells. These data clearly show that patients with c-myc overexpression are high risk patients who thus might benefit from intensive treatment.
早期子宫颈浸润癌的生物学行为并不总是可预测的。因此，识别能够更准确预测疾病进展的新生物学标志物非常重要。在晚期宫颈癌中经常观察到c-myc基因的扩增和/或过表达，并且显示其与肿瘤进展相关。更有趣的是对93例早期癌患者的研究，结果表明c-myc基因过表达与更高的复发风险显著相关。c-myc表达和淋巴结状态的联合能够非常准确地指示复发风险。确实，在淋巴结阴性的患者亚组中，当c-myc以正常水平表达时，3年无病生存率为93%（95%置信区间CI：79-98%），而当c-myc过表达时，该比率仅为51%（95%CI：26-63%）。此外，c-myc过表达与远处转移风险高6.1倍相关，这表明该原癌基因的激活可能导致肿瘤细胞的转移能力。这些数据清楚地表明，c-myc过表达患者是高危患者，因此可能从强化治疗中获益。
