Department of Medical Oncology, Biel-Bienne, Switzerland.
Department of Medical Oncology, Biel-Bienne, Switzerland;
In Vivo. 2021 May-Jun;35(3):1785-1790. doi: 10.21873/invivo.12438.
We report on the case of a 47-year old woman with granulocyte colony-stimulating factor (G-CSF)-producing relapsed oropharyngeal squamous cell cancer. Palliative immunotherapy with nivolumab was started. Absolute neutrophilic count increased during the course of immunotherapy and correlated with tumour progression. Under chemotherapy with weekly paclitaxel, dramatic tumour regression and decreasing absolute neutrophilic count were noted. G-CSF concentration in serum increased from 4.77 to 9.61 pg/ml during the final phase of tumour progression. Immunohistochemical staining of the initial biopsies showed that some of the tumour cells as well as infiltrating cells stained positively for G-CSF, and some of the tumour cells even stained positively for the G-CSF receptor.
Leukaemoid reaction in malignant disease with increased neutrophilic granulocytes has been shown to correlate with dismal prognosis in other tumours. The role of G-CSF in progression and prognosis of head and neck squamous cell carcinomas is still unclear but in patients with these tumours there seems also to be a correlation between elevated G-CSF and poor prognosis. Further systematic evaluation of G-CSF secretion in this tumour entity should clarify the role and potential treatment possibilities for these tumours.
我们报告了一例 47 岁女性，患有粒细胞集落刺激因子 (G-CSF) 产生的复发性口咽鳞状细胞癌。开始进行姑息性免疫治疗用nivolumab。免疫治疗过程中中性粒细胞绝对计数增加，并与肿瘤进展相关。每周紫杉醇化疗后，肿瘤显著缩小，中性粒细胞绝对计数下降。在肿瘤进展的最后阶段，血清中 G-CSF 浓度从 4.77 增加到 9.61pg/ml。最初活检的免疫组织化学染色显示，一些肿瘤细胞和浸润细胞对 G-CSF 呈阳性染色，一些肿瘤细胞甚至对 G-CSF 受体呈阳性染色。
其他肿瘤中已显示白细胞增多的类白血病反应与不良预后相关。G-CSF 在头颈部鳞状细胞癌的进展和预后中的作用尚不清楚，但在这些肿瘤患者中，升高的 G-CSF 似乎也与预后不良相关。进一步系统评估该肿瘤实体中 G-CSF 的分泌情况，应能阐明其在这些肿瘤中的作用和潜在治疗可能性。
