Blatt Sebastian, Krüger Maximilian, Ziebart Thomas, Sagheb Keyvan, Schiegnitz Eik, Goetze Elisabeth, Al-Nawas Bilal, Pabst Andreas Max
Department of Oral and Maxillofacial Surgery (Head: Univ. Prof. Dr. Dr. W. Wagner), University Medical Center, Augustusplatz 2, 55131 Mainz, Germany.
Department of Oral and Maxillofacial Surgery (Head: Univ. Prof. Dr. Dr. W. Wagner), University Medical Center, Augustusplatz 2, 55131 Mainz, Germany.
J Craniomaxillofac Surg. 2017 May;45(5):722-730. doi: 10.1016/j.jcms.2017.01.033. Epub 2017 Feb 16.
Oral squamous cell carcinoma (OSCC) represents the sixth most common cancer, accounting for 2-4% of all malignancies worldwide. The overall survival rate of less than 60% remains generally poor, with prognosis heavily relying on the TNM staging system. Tumor size as well as the presence and extent of lymph node metastases are widely recognized as the most important predictors. However, the underlying mechanisms that lead to an aggressive phenotype are not yet fully understood. Therefore, possible biomarkers are much in need to predict prognosis, to help individualize therapy approaches, and to overcome possible resistance mechanisms. Despite a multitude of recently published biomarkers for OSCC, there is still an ongoing debate regarding their implementation in the clinical workflow. Thus, a systematic literature search via PubMed was performed to update the current literature with the latest evidence. In total, 128 studies were included and over 100 different biomarkers evaluated with reference to their influence of survival, tumor recurrence, advanced grading and lymph node metastasis. In this review, we highlight the important molecular mechanism underlying possible markers in tissue, blood or saliva samples for OSCC. As a major result, no clinical trials could be obtained to prove clinical importance of the validated predictors for survival, tumor recurrence, lymph node metastasis and therapy resistance. Therefore, further clinical investigations are much needed.
口腔鳞状细胞癌（OSCC）是第六大常见癌症，占全球所有恶性肿瘤的2%-4%。总体生存率低于60%，情况普遍较差，预后很大程度上依赖于TNM分期系统。肿瘤大小以及淋巴结转移的存在和范围被广泛认为是最重要的预测指标。然而，导致侵袭性表型的潜在机制尚未完全明确。因此，迫切需要可能的生物标志物来预测预后、帮助实现个体化治疗方案以及克服可能的耐药机制。尽管最近发表了大量关于OSCC的生物标志物，但关于它们在临床工作流程中的应用仍存在争议。因此，通过PubMed进行了系统的文献检索，以用最新证据更新当前文献。总共纳入了128项研究，并评估了100多种不同生物标志物对生存、肿瘤复发、高级别分期和淋巴结转移的影响。在本综述中，我们重点介绍了OSCC组织、血液或唾液样本中可能标志物背后的重要分子机制。主要结果是，无法获得临床试验来证明已验证的预测指标对生存、肿瘤复发、淋巴结转移和治疗耐药性的临床重要性。因此，迫切需要进一步的临床研究。
