Department of Otolaryngology Head and Neck Surgery, The University of Michigan, Ann Arbor, Michigan, USA.
Head Neck. 2013 Mar;35(3):335-42. doi: 10.1002/hed.22973. Epub 2012 Mar 16.
The aim of this study was to investigate oral cancer in pregnant women, a rare but therapeutically challenging patient subset.
After institutional review board approval, an EMERSE search was used to identify all women treated at the University of Michigan from 1998 to 2010 with head and neck squamous cell carcinoma (HNSCC) during pregnancy. This identified 4 patients with tongue cancer. Biomarkers and human papillomavirus (HPV) were assessed by immunohistochemistry and multiplex PCR/mass spectrometry, respectively.
Two patients responded well to therapy and are alive more than 10 years after diagnosis; 2 patients died of disease. All tumors overexpressed EGFR and Bcl-xL, 3 of 4 overexpressed c-Met, both tumors that progressed overexpressed p53. All tumors were negative for HPV, p16, estrogen receptor, progesterone receptor, and HER-2.
Biomarkers of aggressive tumors (high EGFR, c-Met; high Bcl-xL-low p53) did not correlate with outcome. Additional studies are needed to determine whether perineural invasion, delay in diagnosis, and p53 overexpression are factors in poor survival.
本研究旨在探讨口腔癌孕妇这一罕见但治疗极具挑战性的患者亚群。
在获得机构审查委员会批准后，使用 EMERSE 搜索从 1998 年至 2010 年在密歇根大学接受治疗的所有患有头颈部鳞状细胞癌（HNSCC）的孕妇，确定了 4 例舌癌患者。通过免疫组织化学和多重 PCR/质谱法分别评估生物标志物和人乳头瘤病毒（HPV）。
2 例患者对治疗反应良好，在诊断后 10 年以上仍存活；2 例患者死于疾病。所有肿瘤均过度表达 EGFR 和 Bcl-xL，4 例中有 3 例过度表达 c-Met，进展的肿瘤均过度表达 p53。所有肿瘤均为 HPV、p16、雌激素受体、孕激素受体和 HER-2 阴性。
侵袭性肿瘤的生物标志物（高 EGFR、c-Met；高 Bcl-xL-低 p53）与预后无关。需要进一步研究以确定神经周围侵犯、诊断延迟和 p53 过度表达是否是生存率降低的因素。
