Division of Medical Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
Oral Oncol. 2012 Oct;48(10):985-990. doi: 10.1016/j.oraloncology.2012.04.013. Epub 2012 Jun 8.
The aims of this study were to evaluate the expression of EGFR, PI3K, Akt, mTOR, and PTEN in the oral cavity and oropharyngeal cancers, and to investigate their clinical significance as prognostic markers.
One hundred twenty-one patients who underwent curative surgery for oral cavity or oropharyngeal squamous cell carcinoma in Seoul St. Mary's Hospital between January 1995 and September 2009 were evaluated. The level of protein expression of EGFR, PIK3CA, pAkt, mTOR, and PTEN was assessed by immunohistochemistry. In situ hybridization was used to detect the existence of human papillomavirus (HPV).
Nineteen of 61 patients with oropharyngeal cancer showed HPV-positive tumors, and two of 60 patients with oral cavity cancer showed HPV-positive tumors. EGFR and pAkt expression was significantly higher in oral cavity cancers than in oropharyngeal cancers. Loss of PTEN occurred significantly more frequently in oral cavity cancers than in oropharyngeal cancers. The expression levels of PIK3CA, mTOR, and p53 did not differ significantly between the two cancers. Overexpression of EGFR and pAkt and loss of PTEN were observed more frequently in HPV-negative tumors. Multivariate Cox regression analysis showed that pAkt expression had a significantly unfavorable impact on relapse-free survival in oropharyngeal cancer.
We conclude that the expression levels of EGFR, pAkt, and PTEN differ between oropharyngeal and oral cavity cancer and it may be attributed to HPV-related molecular pathogenesis. The expression of pAkt might be an unfavorable prognostic marker for relapse-free survival in oropharyngeal cancer.
本研究旨在评估 EGFR、PI3K、Akt、mTOR 和 PTEN 在口腔和口咽癌中的表达，并探讨其作为预后标志物的临床意义。
评估了 1995 年 1 月至 2009 年 9 月期间在首尔圣玛丽医院接受根治性手术治疗的 121 例口腔或口咽鳞状细胞癌患者。通过免疫组织化学评估 EGFR、PI3KCA、pAkt、mTOR 和 PTEN 的蛋白表达水平。原位杂交用于检测人乳头瘤病毒（HPV）的存在。
61 例口咽癌患者中有 19 例为 HPV 阳性肿瘤，60 例口腔癌患者中有 2 例为 HPV 阳性肿瘤。与口咽癌相比，口腔癌中 EGFR 和 pAkt 的表达明显更高。口腔癌中 PTEN 缺失的发生率明显高于口咽癌。PI3KCA、mTOR 和 p53 的表达水平在两种癌症之间无显著差异。在 HPV 阴性肿瘤中观察到 EGFR 和 pAkt 的过度表达以及 PTEN 的缺失更为频繁。多变量 Cox 回归分析显示，pAkt 表达对口咽癌无复发生存率有显著不利影响。
我们得出结论，EGFR、pAkt 和 PTEN 的表达水平在口咽癌和口腔癌之间存在差异，这可能归因于 HPV 相关的分子发病机制。pAkt 的表达可能是口咽癌无复发生存率的不利预后标志物。
