Gualtieri Tommaso, Bonomo Pierluigi, Sottili Mariangela, Mangoni Monica, Lavarone Alessandra, Russo Monica Lo, Desideri Isacco, Livi Lorenzo, Deganello Alberto
Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Radiation Oncology, Department of Experimental and Clinical Biomedical Sciences, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
Clin Transl Radiat Oncol. 2020 Apr 23;23:60-64. doi: 10.1016/j.ctro.2020.04.008. eCollection 2020 Jul.
In a pilot prospective study, we aimed to test the feasibility and report on the preliminary results on the expression of molecular biomarkers in wound drainage fluids (WDFs) of operated head and neck squamous cell carcinoma (HNSCC) patients.
Nineteen patients undergoing primary tumor resection with en-block neck dissection were enrolled. In postoperative days 1-3, the expression of several biomarkers in WDFs was measured using enzyme-linked immunosorbent assay (ELISA) kits and correlated with clinical and histopathologic features.
The expression of stromal cell-derived factor 1 (CXCL-12) was significantly increased in WDFs in presence of lymph node metastases, extranodal extension (ENE), and in case of close resection margins. In addition, Osteopontin expression was significantly increased in presence of ENE, whereas transforming growth factor beta (TGF-β) detection was significantly reduced. At multivariate analysis, CXCL-2 levels in both day 1 and 3 post-surgery were the only factor which retained significance in the prediction of close surgical margins (p = 0.028 and 0.025 for day 1 and day 3, respectively). Both CXCL-2 and Ostepontin assays were significantly correlated with ENE (p = 0.018 and 0.035 for day 1; 0.052 and 0.025 for day 3, respectively) whereas TGF- β expression was significant at day 1 only (p = 0.038).
Our pilot study showed that WDFs could qualify as a potential source of relevant postoperative information. Further studies are needed to confirm the prognostic impact of CXCL-12, Osteopontin and TGF-β expressed in WDFs on the personalized management of HNSCC.
在一项前瞻性试点研究中，我们旨在测试可行性，并报告关于接受手术的头颈部鳞状细胞癌（HNSCC）患者伤口引流液（WDF）中分子生物标志物表达的初步结果。
纳入19例接受原发肿瘤切除并整块颈清扫术的患者。在术后第1 - 3天，使用酶联免疫吸附测定（ELISA）试剂盒测量WDF中几种生物标志物的表达，并将其与临床和组织病理学特征相关联。
在存在淋巴结转移、结外扩展（ENE）以及手术切缘接近的情况下，WDF中基质细胞衍生因子1（CXCL-12）的表达显著增加。此外，在存在ENE的情况下骨桥蛋白表达显著增加，而转化生长因子β（TGF-β）检测显著降低。在多变量分析中，术后第1天和第3天的CXCL-2水平是预测手术切缘接近的唯一具有显著意义的因素（第1天和第3天的p值分别为0.028和0.025）。CXCL-2和骨桥蛋白检测均与ENE显著相关（第1天分别为p = 0.018和0.035；第3天分别为0.052和0.025），而TGF-β表达仅在第1天具有显著意义（p = 0.038）。
我们的试点研究表明，WDF可作为术后相关信息的潜在来源。需要进一步研究来证实WDF中表达的CXCL-12、骨桥蛋白和TGF-β对HNSCC个体化管理的预后影响。
