Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Kerpenerstrasse 62, 50937 Cologne, Germany.
Oral Oncol. 2011 Sep;47(9):873-8. doi: 10.1016/j.oraloncology.2011.06.508. Epub 2011 Jul 20.
Despite new therapeutic approaches patients with advanced oral squamous cell carcinoma still have a dismal prognosis. The main factor contributing to this problem is locoregional failure due to a lack of response to treatment. Several trials have proven the effect of neoadjuvant radiochemotherapy followed by radical surgery in comparison to primary surgery followed by adjuvant radiochemotherapy. No reliable parameters have been identified so far to predict response to radiochemotherapy. The aim of our study was to assess whether podoplanin expression in pretreatment biopsies could serve as a biomarker to predict the host response to neoadjuvant radiochemotherapy. In this retrospective study, podoplanin expression was examined in a set of 63 patients with oral squamous cell carcinoma by immunohistochemistry. We analyzed associations between the level of podoplanin expression and various clinicopathologic parameters, including response to radiochemotherapy, clinical and histological N-status. Furthermore we evaluated the effects of these parameters on overall survival and on locoregional control in univariate and multivariate analysis. The χ(2)-test revealed that high expression of podoplanin in pretreatment biopsy material was associated with non-regression of the tumor (p=0.013) and poor overall survival (p<0.001). Five-year survival rates of 92.9% for patients with weak expression and 15.0% for high expression were revealed. Podoplanin expression was also significantly associated with ypN status (p=0.004) and ypUICC status (p<0.001). We concluded that podoplanin might serve as a factor to predict treatment response in oral squamous cell carcinoma treated with neoadjuvant platin-based radiochemotherapy as well as a prognostic factor for overall survival and locoregional control.
尽管采用了新的治疗方法，晚期口腔鳞状细胞癌患者的预后仍然很差。造成这一问题的主要因素是由于缺乏治疗反应而导致的局部区域失败。几项试验已经证明了新辅助放化疗后行根治性手术与初始手术后继以辅助放化疗相比的疗效。迄今为止，尚未确定任何可靠的参数来预测放化疗的反应。我们的研究旨在评估治疗前活检中的 podoplanin 表达是否可以作为预测宿主对新辅助放化疗反应的生物标志物。在这项回顾性研究中，我们通过免疫组织化学方法检测了 63 例口腔鳞状细胞癌患者的 podoplanin 表达。我们分析了 podoplanin 表达水平与各种临床病理参数之间的关系，包括对放化疗的反应、临床和组织学 N 分期。此外，我们还在单变量和多变量分析中评估了这些参数对总生存和局部区域控制的影响。卡方检验显示，治疗前活检材料中 podoplanin 的高表达与肿瘤的非消退（p=0.013）和总生存率差（p<0.001）相关。弱表达的患者 5 年生存率为 92.9%，高表达的患者为 15.0%。Podoplanin 表达也与 ypN 分期（p=0.004）和 ypUICC 分期（p<0.001）显著相关。我们得出结论，podoplanin 可能作为预测接受新辅助基于铂类放化疗的口腔鳞状细胞癌治疗反应的因素以及总生存和局部区域控制的预后因素。
