Office of Academia and Research in Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Department of Biosciences, Faculty of Life Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan.
Int J Surg Oncol. 2022 Mar 7;2022:9990489. doi: 10.1155/2022/9990489. eCollection 2022.
Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. . Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment naïve OSCC. The immunoreactivity for each marker was correlated with patient clinicopathologic characteristics, oral cancer risk chewing habits, and survival. The minimum follow-up time for all patients was five years, and survival estimates were calculated using the Kaplan-Meier method and Cox proportional hazards model. . In this cohort of 100 patients, there were 57 males and 43 females. The median OS and DFS time durations observed were 64 and 52.5 months, respectively. Positive expression for CD44, CD133, L1CAM, and SOX2 was observed in 33%, 23%, 41%, and 63% of patients. High CD44 expression correlated with decreased OS (=0.047) but did not influence DFS. However, CD133, L1CAM, and SOX2 had no effect on either OS or DFS. Tonsils, nodal involvement, and AJCC stage were independent predictors of worse OS and DFS both. . Of the CSC markers investigated here, only CD44 was a predictor for poor OS. CD44 was also associated with advanced AJCC and T stages. Interestingly, CD133 was significantly lower in patients who habitually consumed oral cancer risk factors.
口腔鳞状细胞癌（OSCC）在巴基斯坦人群中排名第一，几十年来，患者的生存率一直保持在约 50%左右。最近的研究进展声称，肿瘤细胞的一个亚群，称为癌症干细胞（CSC），是肿瘤进展、治疗耐药和转移的原因，导致预后不良。本研究调查了 CSC 标志物表达对 OSCC 患者总生存（OS）和无病生存（DFS）的影响。采用免疫组织化学方法评估了 100 名未经初治的巴基斯坦原发性 OSCC 患者中 CD44、CD133、L1CAM 和 SOX2 的表达。对每个标志物的免疫反应性与患者的临床病理特征、口腔癌高危咀嚼习惯和生存情况进行了相关性分析。所有患者的最小随访时间为 5 年，生存估计采用 Kaplan-Meier 方法和 Cox 比例风险模型进行计算。在这 100 名患者的队列中，男性 57 例，女性 43 例。观察到的中位 OS 和 DFS 时间分别为 64 个月和 52.5 个月。CD44、CD133、L1CAM 和 SOX2 的阳性表达率分别为 33%、23%、41%和 63%。CD44 高表达与 OS 降低相关（=0.047），但不影响 DFS。然而，CD133、L1CAM 和 SOX2 对 OS 或 DFS 均无影响。扁桃体、淋巴结受累和 AJCC 分期是 OS 和 DFS 不良的独立预测因素。在本研究中调查的 CSC 标志物中，只有 CD44 是 OS 不良的预测因子。CD44 也与 AJCC 分期和 T 分期较高有关。有趣的是，习惯性食用口腔癌危险因素的患者中 CD133 明显降低。
