Khandelwal Alok R, Ma Xiaohui, Egan Paige, Kaskas Nadine M, Moore-Medlin Tara, Caldito Gloria, Abreo Fleurette, Gu Xin, Aubrey Lurie, Milligan Edward, Nathan Cherie-Ann O
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA Department of Surgery, Overton Brooks Veterans Medical Center, Shreveport, Louisiana, USA.
Otolaryngol Head Neck Surg. 2016 Aug;155(2):281-8. doi: 10.1177/0194599816641913. Epub 2016 Apr 19.
Aggressive cutaneous squamous cell carcinoma (cSCC) patients are at increased risk of metastasis. Currently, there are no accepted criteria or biomarkers for reliably predicting individuals at risk for recurrence and metastasis. Our objective is to determine if pS6 and pERK can predict cSCC aggressiveness and to identify primary tumor characteristics that may predict parotid metastasis.
Retrospective case series.
Tertiary care center.
An Institutional Review Board-approved retrospective review was performed for patients with facial cSCC, with and without metastasis to the parotids. Subjects for the study were identified through the Louisiana Tumor Registry, Veterans Medical Records, and LSU Health-Shreveport pathology database. Tumor specimens from patients with cSCC and cSCC with parotid metastasis were analyzed for pERK and pS6 expression through immunohistochemistry. To identify risk factors for tumor aggressiveness, multiple logistic regression analysis was used to evaluate patients with cSCC that was metastatic to the parotid and managed surgically.
cSCC with parotid metastasis specimens exhibited significantly higher average pS6 but not pERK positivity than those from cSCC without metastasis (P < .05). Primary lesion-positive margins (P < .01), size of the skin tumor (P < .01) and degree of tumor differentiation (P < .01) were significantly associated with parotid metastasis.
Surgical history of cSCC, primary lesion-positive margins, degree of differentiation, and lesion size together with pS6 positivity appear to be predictors of cSCC aggressiveness and should prompt increased monitoring or elective parotidectomy.
侵袭性皮肤鳞状细胞癌（cSCC）患者发生转移的风险增加。目前，尚无公认的标准或生物标志物可可靠预测有复发和转移风险的个体。我们的目的是确定pS6和pERK是否可预测cSCC的侵袭性，并确定可能预测腮腺转移的原发性肿瘤特征。
回顾性病例系列研究。
三级医疗中心。
对经机构审查委员会批准，对有或无腮腺转移的面部cSCC患者进行回顾性研究。通过路易斯安那肿瘤登记处、退伍军人医疗记录和路易斯安那州立大学健康科学中心什里夫波特分校病理数据库确定研究对象。通过免疫组织化学分析cSCC患者和发生腮腺转移的cSCC患者的肿瘤标本中pERK和pS6的表达。为了确定肿瘤侵袭性的危险因素，采用多因素logistic回归分析评估发生腮腺转移并接受手术治疗的cSCC患者。
发生腮腺转移的cSCC标本中pS6的平均阳性率显著高于无转移的cSCC标本，但pERK阳性率无显著差异（P <.05）。原发性病变切缘阳性（P <.01）、皮肤肿瘤大小（P <.01）和肿瘤分化程度（P <.01）与腮腺转移显著相关。
cSCC的手术史、原发性病变切缘阳性、分化程度、病变大小以及pS6阳性似乎是cSCC侵袭性的预测指标，应加强监测或进行选择性腮腺切除术。
