Department of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
J Oral Pathol Med. 2012 Jan;41(1):40-6. doi: 10.1111/j.1600-0714.2011.01071.x. Epub 2011 Aug 29.
The purpose of this study was to evaluate whether the immunohistochemical expression of p53, p21, p27, cyclin D1, and Ki67 can predict therapy response and survival in patients with oral and oropharyngeal squamous cell carcinoma treated with preoperative chemoradiation.
Biomarker expression was evaluated by immunohistochemistry in formalin-fixed, paraffin-embedded pretreatment biopsies of 111 homogenously treated patients. We assessed the association between clinicopathological variables including response to neoadjuvant chemoradiotherapy as well as the survival of the patients and the expression of the biomarkers as both dichotomized (positive vs. negative) and continuous variables.
Biomarker overexpression on the basis of pre-selected cutoff points was seen in 66 of 111 (59%) cases for p53, in 77 (69%) for p21, in 48 (43%) for p27, in 81 (73%) for cyclin D1, and in 54 (49%) cases for Ki67, respectively. None of the examined biomarkers was able to predict response to neoadjuvant chemoradiotherapy or was associated with survival outcome. Post-treatment pathologic TNM stage (P < 0.001), pathologic response (P < 0.001), and perineural invasion (P < 0.001) were the only factors having a significant effect on recurrence-free survival. Post-treatment pathologic N stage (P = 0.005), post-treatment pathologic TNM stage (P < 0.001), pathologic response (P < 0.001), and perineural invasion (P = 0.001) had a significant impact on overall survival.
Our results suggest that the biomarkers p53, p21, p27, cyclin D1, and Ki67 have no impact on treatment response and survival in patients with oral and oropharyngeal cancer treated with preoperative chemoradiation.
本研究旨在评估在接受术前放化疗的口腔和口咽鳞状细胞癌患者中，p53、p21、p27、cyclin D1 和 Ki67 的免疫组织化学表达是否可以预测治疗反应和生存。
通过免疫组织化学评估 111 例均质治疗患者的福尔马林固定、石蜡包埋预处理活检中的生物标志物表达。我们评估了包括对新辅助放化疗的反应在内的临床病理变量与患者生存之间的关联，以及生物标志物的表达作为二分类（阳性与阴性）和连续变量的表达。
在 111 例病例中，基于预先选择的截断点，p53 的过度表达见于 66 例（59%），p21 为 77 例（69%），p27 为 48 例（43%），cyclin D1 为 81 例（73%），Ki67 为 54 例（49%）。在接受新辅助放化疗的患者中，没有一种检查的生物标志物能够预测反应或与生存结果相关。治疗后病理 TNM 分期（P < 0.001）、病理反应（P < 0.001）和神经周围侵犯（P < 0.001）是对无复发生存有显著影响的唯一因素。治疗后病理 N 分期（P = 0.005）、治疗后病理 TNM 分期（P < 0.001）、病理反应（P < 0.001）和神经周围侵犯（P = 0.001）对总生存有显著影响。
我们的结果表明，在接受术前放化疗的口腔和口咽癌患者中，生物标志物 p53、p21、p27、cyclin D1 和 Ki67 对治疗反应和生存没有影响。
