生物或放化疗治疗的头颈部癌症患者组织坏死、缺氧相关标志物的预后价值及其与 HPV 状态的相关性。
Prognostic value of tissue necrosis, hypoxia-related markers and correlation with HPV status in head and neck cancer patients treated with bio- or chemo-radiotherapy.
机构信息
Department of Radiation Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Pathology, Gustave Roussy, Paris-Saclay University, Villejuif, France.
出版信息
Radiother Oncol. 2018 Jan;126(1):116-124. doi: 10.1016/j.radonc.2017.10.007. Epub 2017 Nov 1.
BACKGROUND AND PURPOSE
The aim of the present study was to investigate the role of three hypoxia-related biomarkers in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) treated with concurrent chemoradiotherapy (3-weekly cisplatin) or bioradiotherapy (weekly cetuximab).
MATERIAL AND METHODS
In tumor tissue material from 100 patients with known HPV status, we evaluated the extent of tumor necrosis, the expression level of CA-IX and the microvascular density (MVD) measured as the density of CD34+ vascular structures. The correlations between biomarker expressions and clinicopathological characteristics and treatment outcomes were analyzed.
RESULTS
We found a significant correlation of MVD with UICC stage (p = 0.02) and T classification (p = 0.05), of CA-IX with UICC stage (p = 0.03) and N classification (p = 0.04) and a significant inverse correlation of MVD with CA-IX expression (r = -0.22, p = 0.03). Multivariate analysis showed that low MVD combined with high CA IX-expression was a significant independent prognostic factor for worse loco-regional control (HR = 2.6, 95%CI 1.1-5.0, p = 0.02) in the whole population but not in the p16+ subgroup. Patients treated with CRT had a better LRC than those with BRT independent of MVD or CA-IX expression.
CONCLUSIONS
The combination of MVD and CA-IX expression might give additional prognostic information in HNSCC patients with known HPV status.
背景与目的
本研究旨在探讨三种与缺氧相关的生物标志物在接受同期放化疗（每周顺铂）或生物放化疗（每周西妥昔单抗）治疗的局部晚期头颈部鳞状细胞癌（HNSCC）患者中的作用。
材料与方法
在 100 例已知 HPV 状态的患者的肿瘤组织标本中，我们评估了肿瘤坏死程度、CA-IX 的表达水平以及微血管密度（MVD），即 CD34+血管结构的密度。分析了生物标志物表达与临床病理特征和治疗结果之间的相关性。
结果
我们发现 MVD 与 UICC 分期（p=0.02）和 T 分类（p=0.05）、CA-IX 与 UICC 分期（p=0.03）和 N 分类（p=0.04）显著相关，而 MVD 与 CA-IX 表达呈显著负相关（r=-0.22，p=0.03）。多变量分析显示，低 MVD 结合高 CA-IX 表达是全人群局部区域控制（HR=2.6，95%CI 1.1-5.0，p=0.02）更差的独立预后因素，但在 p16+亚组中并非如此。接受 CRT 治疗的患者的 LRC 优于接受 BRT 治疗的患者，无论 MVD 或 CA-IX 表达如何。
结论
在已知 HPV 状态的 HNSCC 患者中，MVD 和 CA-IX 表达的联合可能提供额外的预后信息。
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