Department of Neuroscience DNS, Audiology Unit, University of Padova, Treviso, Italy.
Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
Ann Diagn Pathol. 2020 Apr;45:151471. doi: 10.1016/j.anndiagpath.2020.151471. Epub 2020 Jan 20.
Comprehension of the interplay of pro-apoptotic and anti-apoptotic stimuli in laryngeal squamous cell carcinoma (LSCC) is crucial to understand tumor development, biological behavior and treatment response. Bcl-2 family proteins mainly regulate the apoptotic signal cascade. In some cancers, maspin seems to influence the balance between pro-apoptosis and anti-apoptosis bcl-2 family proteins. The aim of this study was to investigate the potential relationship between bcl-2 anti-apoptotic factor and the tumor suppressor maspin in LSCC.
31 consecutive patients who underwent primary surgery and post-operative radiotherapy for LSCC were evaluated retrospectively. For each case, immunohistochemistry assays for bcl-2 and maspin were performed. Data were also collected on N-status, pT stage, grading, recurrence and disease-free survival (DFS).
Patients with nuclear maspin pattern of expression showed a significantly lower recurrence rate (p = 0.04) and longer DFS (p = 0.0018). The expression of bcl-2 was not associated with recurrence rate or DFS either in the whole cohort or in cases with nuclear maspin pattern, while in patients with non-nuclear maspin pattern, a statistical trend was found toward a shorter DFS for bcl-2 positive cases (p = 0.062). In the multivariate model, only maspin expression pattern retained its independent prognostic significance (p = 0.006).
Nuclear maspin pattern seemed to be an independent positive prognostic factor, while bcl-2 prognostic value was related to maspin expression pattern. Further investigations are needed to support the use of bcl-2 inhibitors in multimodality or multitarget strategies against advanced LSCCs, also considering the role and expression of tumor suppressor genes.
理解促凋亡和抗凋亡刺激在喉鳞状细胞癌（LSCC）中的相互作用对于理解肿瘤的发展、生物学行为和治疗反应至关重要。Bcl-2 家族蛋白主要调节凋亡信号级联。在某些癌症中，maspin 似乎影响促凋亡和抗凋亡 bcl-2 家族蛋白之间的平衡。本研究旨在探讨 LSCC 中 bcl-2 抗凋亡因子与肿瘤抑制因子 maspin 之间的潜在关系。
回顾性评估了 31 例接受 LSCC 根治性手术和术后放疗的连续患者。对每个病例均进行了 bcl-2 和 maspin 的免疫组织化学检测。还收集了 N 分期、pT 分期、分级、复发和无病生存（DFS）的数据。
具有核 maspin 表达模式的患者复发率明显较低（p=0.04），DFS 较长（p=0.0018）。bcl-2 的表达与整个队列的复发率或 DFS 均无关，也与核 maspin 模式的病例无关，而在非核 maspin 模式的病例中，bcl-2 阳性病例的 DFS 有缩短的趋势（p=0.062）。在多变量模型中，只有 maspin 表达模式保留了其独立的预后意义（p=0.006）。
核 maspin 模式似乎是一个独立的阳性预后因素，而 bcl-2 的预后价值与 maspin 表达模式有关。需要进一步的研究来支持在多模态或多靶点策略中使用 bcl-2 抑制剂来治疗晚期 LSCC，同时考虑肿瘤抑制基因的作用和表达。
