Rades Dirk, Huttenlocher Stefan, Seibold Nina D, Gebhard Maximilian P, Thorns Christoph, Hasselbacher Katrin, Wollenberg Barbara, Schild Steven E
BMC Cancer. 2015 Mar 6;15:102. doi: 10.1186/s12885-015-1107-2.
This study investigated the prognostic role of nuclear expression of p65 in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) receiving post-operative radio(chemo)therapy.
Nuclear p65-expression (H-score ≤50 versus >50) plus twelve characteristics were analyzed in 151 patients for overall survival (OS), metastases-free survival (MFS) and loco-regional control (LRC). Additional characteristics included age, gender, Karnofsky performance score (KPS), pre-radiotherapy hemoglobin levels, tumor site, histological grading, human papilloma virus (HPV)-status, T-classification, N-classification, American Joint Committee on Cancer (AJCC)-stage, extent of resection and concurrent chemotherapy. Univariate analyses were performed with Kaplan-Meier method and log-rank test, multivariate analyses with Cox proportional hazards model.
On univariate analyses, p65-expression had a significant impact on OS (p < 0.001) and LRC (p < 0.001) but not on MFS (p = 0.29). On multivariate analysis, KPS ≥80 (risk ratio [RR] 2.23; p = 0.012), HPV-positivity (RR 5.83; p = 0.020), T1-T2 (RR 1.38; p = 0.048), N0-N2a (RR 2.72; p = 0.005) and complete resection (RR 2.02; p = 0.049) were positively associated with OS; p65-negativity achieved borderline significance (RR 3.02; p = 0.052). Better MFS was associated with KPS ≥80 (RR 2.49; p = 0.015), T1-T2 (RR: 1.74; p = 0.005), N0-N2a (RR: 6.22; p < 0.001) and complete resection (RR 3.43; p = 0.003). Positive associations with LRC were found for p65-negativity (RR 5.06; p = 0.008), T1-T2 (RR: 1.49; p = 0.022), N0-N2a (RR: 2.97; p = 0.004) and favorable tumor site (RR 1.28; p = 0.025).
P65-negativity was significantly associated with improved LRC and achieved borderline significance with respect to improved OS. Thus, p65-expression may be an additional target for novel agents in the treatment of locally advanced SCCHN.
本研究调查了p65核表达在接受术后放（化）疗的局部晚期头颈部鳞状细胞癌（SCCHN）患者中的预后作用。
分析了151例患者的核p65表达（H评分≤50与>50）以及12项特征，以评估总生存期（OS）、无转移生存期（MFS）和局部区域控制（LRC）。其他特征包括年龄、性别、卡诺夫斯基性能评分（KPS）、放疗前血红蛋白水平、肿瘤部位、组织学分级、人乳头瘤病毒（HPV）状态、T分类、N分类、美国癌症联合委员会（AJCC）分期、切除范围和同步化疗。采用Kaplan-Meier法和对数秩检验进行单因素分析，采用Cox比例风险模型进行多因素分析。
单因素分析中，p65表达对OS（p<0.001）和LRC（p<0.001）有显著影响，但对MFS无影响（p = 0.29）。多因素分析中，KPS≥80（风险比[RR] 2.23；p = 0.012）、HPV阳性（RR 5.83；p = 0.020）、T1-T2（RR 1.38；p = 0.048）、N0-N2a（RR 2.72；p = 0.005）和完全切除（RR 2.02；p = 0.049）与OS呈正相关；p65阴性达到临界显著性（RR 3.02；p = 0.052）。更好的MFS与KPS≥80（RR 2.49；p = 0.015）、T1-T2（RR：1.74；p = 0.005）、N0-N2a（RR：6.22；p<0.001）和完全切除（RR 3.43；p = 0.003）相关。p65阴性（RR 5.06；p = 0.008）、T1-T2（RR：1.49；p = 0.022）、N0-N2a（RR：2.97；p = 0.004）和良好的肿瘤部位（RR 1.28；p = 0.025）与LRC呈正相关。
p65阴性与改善LRC显著相关，在改善OS方面达到临界显著性。因此，p65表达可能是治疗局部晚期SCCHN新药物的一个额外靶点。
