Broglie Martina A, Soltermann Alex, Haile Sarah R, Huber Gerhard F, Stoeckli Sandro J
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland,
Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1755-62. doi: 10.1007/s00405-014-3099-y. Epub 2014 Jun 1.
Impact of p16 protein, a surrogate marker for human papilloma virus induced cancer, p53 and EGFR as well as clinical factors on survival in a patient cohort with oropharyngeal squamous cell carcinoma (OPSCC) treated by surgical resection and adjuvant radiotherapy (RT) ± concomitant chemotherapy (CT). This is a retrospective analysis of patient's charts and tumor tissue. 57 patients were consecutively included and their tumor tissue assembled on a tissue microarray following immunohistochemical analysis. Survival times were estimated by means of Kaplan-Meier analysis. The importance of clinical and immunohistochemical factors for outcome was estimated by cox proportional hazard models. With 88% 5-year overall survival, 91% 5-year disease-specific survival and 91% 5-year disease-free survival, respectively, we found excellent survival rates in this surgically treated patient cohort of mainly advanced OPSCC (93% AJCC stage III or IV). The only factors positively influencing survival were p16 overexpression as well as p53 negativity and even more pronounced the combination of those biomarkers. Survival analysis of patients classified into three risk categories according to an algorithm based on p16, smoking, T- and N-category revealed a low, intermediate and high-risk group with significant survival differences between the low and the high-risk group. Patients with OPSCC can be successfully treated by surgery and adjuvant RT ± CT with a clear survival benefit of p16 positive, p53 negative patients. We recommend considering a combination of immunohistochemical (p16, p53) and clinical factors (smoking, T- and N-category) for risk stratification.
人乳头瘤病毒诱导癌的替代标志物p16蛋白、p53和表皮生长因子受体（EGFR）以及临床因素对接受手术切除和辅助放疗（RT）±同步化疗（CT）的口咽鳞状细胞癌（OPSCC）患者队列生存的影响。这是一项对患者病历和肿瘤组织的回顾性分析。连续纳入57例患者，并在免疫组织化学分析后将其肿瘤组织制成组织微阵列。通过Kaplan-Meier分析估计生存时间。通过Cox比例风险模型估计临床和免疫组织化学因素对预后的重要性。在这个主要为晚期OPSCC（93%为美国癌症联合委员会III期或IV期）的手术治疗患者队列中，我们分别发现5年总生存率为88%、5年疾病特异性生存率为91%和5年无病生存率为91%，生存率极佳。唯一对生存有积极影响的因素是p16过表达以及p53阴性，而这些生物标志物的联合影响更为显著。根据基于p16、吸烟、T分期和N分期的算法将患者分为三个风险类别进行生存分析，结果显示低风险、中风险和高风险组，低风险组和高风险组之间存在显著的生存差异。OPSCC患者通过手术和辅助RT±CT可以成功治疗，p16阳性、p53阴性患者有明显的生存获益。我们建议考虑将免疫组织化学（p16、p53）和临床因素（吸烟、T分期和N分期）结合用于风险分层。
