Yoshida Shinya, Wakisaka Naohiro, Kondo Satoru, Moriyama-Kita Makiko, Hirai Nobuyuki, Endo Kazuhira, Tsuji Akira, Nakanishi Yosuke, Murono Shigeyuki, Yoshizaki Tomokazu
a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
Acta Otolaryngol. 2016;136(2):189-94. doi: 10.3109/00016489.2015.1103381. Epub 2015 Nov 2.
SPARC-expression is an indicator of the prognosis in terms of OS, independent of HPV-infection. HPV-negative patients with SPARC-Low show survival as favorable as HPV-positive patients, probably because of their higher salvage rate after relapse than SPARC-High patients.
The objectives of the study were to clarify the correlation between the expression of secreted protein acidic and rich in cysteine (SPARC) and HPV-status, and to determine the prognostic value of SPARC-expression in oropharyngeal squamous cell carcinoma (OPSCC) patients.
Fifty-three formalin-fixed and paraffin-embedded tissues were obtained from patients with OPSCC who underwent curative treatment. The SPARC protein was detected by immunohistochemistry. SPARC-expression level was divided into two categories, SPARC-High and SPARC-Low, according to the staining index.
Twenty-two out of the 53 OPSCC patients were HPV-positive. There was no significant correlation between the HPV-status and SPARC-expression level. Multivariate Cox proportional hazards regression analysis revealed that the HPV-status and SPARC-expression are independent prognostic indicators of favorable and unfavorable overall survival (OS) (p = 0.021 and p = 0.012), respectively. For disease-free survival, the HPV-status was the only predictive factor (p = 0.022). After stratification by the HPV-status, high SPARC-expression was a significant predictor of poor OS in HPV-negative OPSCC patients using Kaplan-Meier analysis and the log-rank test (p = 0.014). Ten out of 28 SPARC-Low patients relapsed, among which six patients (60%) were salvaged. However, 14 out of 25 SPARC-High patients relapsed, and only three patients (21.4%) were salvaged.
SPARC表达是总生存期预后的一个指标，独立于HPV感染。SPARC低表达的HPV阴性患者与HPV阳性患者的生存率相似，这可能是因为他们复发后的挽救率高于SPARC高表达患者。
本研究的目的是阐明富含半胱氨酸的酸性分泌蛋白（SPARC）表达与HPV状态之间的相关性，并确定SPARC表达在口咽鳞状细胞癌（OPSCC）患者中的预后价值。
从接受根治性治疗的OPSCC患者中获取53份福尔马林固定石蜡包埋组织。通过免疫组织化学检测SPARC蛋白。根据染色指数，将SPARC表达水平分为SPARC高表达和SPARC低表达两类。
53例OPSCC患者中有22例HPV阳性。HPV状态与SPARC表达水平之间无显著相关性。多因素Cox比例风险回归分析显示，HPV状态和SPARC表达分别是总生存期（OS）良好和不良的独立预后指标（p = 0.021和p = 0.012）。对于无病生存期，HPV状态是唯一的预测因素（p = 0.022）。通过HPV状态分层后，使用Kaplan-Meier分析和对数秩检验，高SPARC表达是HPV阴性OPSCC患者OS不良的显著预测因素（p = 0.014）。28例SPARC低表达患者中有10例复发，其中6例（60%）得到挽救。然而，25例SPARC高表达患者中有14例复发，只有3例（21.4%）得到挽救。
