Carrillo José F, Cruz-Romero Christian, Avilés-Salas Alejandro, Carrillo Liliana C, Ramírez-Ortega Margarita C, Herrera-Goepfert Roberto, Vázquez-Romo Rafael, Figueroa-González Gabriela, Altamirano-García Javier I, Oñate-Ocaña Luis F
Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, Mexico City, Mexico.
Departamento de Patología, Instituto Nacional de Cancerología, Mexico City, Mexico.
Ann Surg Oncol. 2022 Mar 23. doi: 10.1245/s10434-022-11544-x.
The expression of liver kinase B1 (LKB-1) has been associated with prognosis in squamous cell carcinoma of the oral cavity (SCCOC). This study aimed to define the prognostic role of LKB-1 expression for patients with SCCOC and the suitability of its integration into a multivariate prognostic model.
A retrospective cohort study of patients with SCCOC was conducted in a cancer center. Expression of LKB-1 was evaluated by immunohistochemistry, and multivariate analysis defined prognostic factors associated with recurrence, recurrence-free survival (RFS), and overall survival (OS). The logistic regression model was used to construct a predictive computer software program.
Of the 201 patients in this study, 104 (51.7%) experienced recurrence of their disease. Lower expression of LKB-1, high-risk histopathology, and advanced tumor-node-metastasis (TNM) stages were independent factors via multivariate analysis associated with the increased recurrence risk, poor RFS, and poor OS. If lack of LKB-1 expression is considered the reference category, the factors independently associated with recurrence were low (odds ratio [OR], 0.157; 95% confidence interval [CI], 0.044-0.557), intermediate (OR, 0.073; 95% CI, 0.017-0.319), and intense (OR, 0.047; 95% CI, 0.007-0.304) expression of LKB-1. This model permitted construction of a computer software program capable of prediction with receiver operating characteristic analysis (area under the curve, 0.925) and led to the definition of five prognostic groups with a biologic gradient.
These results suggest that LKB-1 expression in patients with SCCOC is of robust prognostic value and complements the TNM staging system. The proposed model requires external validation in prospective observational studies.
肝脏激酶B1（LKB-1）的表达与口腔鳞状细胞癌（SCCOC）的预后相关。本研究旨在确定LKB-1表达对SCCOC患者的预后作用及其纳入多因素预后模型的适用性。
在一家癌症中心对SCCOC患者进行了一项回顾性队列研究。通过免疫组织化学评估LKB-1的表达，并进行多因素分析以确定与复发、无复发生存期（RFS）和总生存期（OS）相关的预后因素。使用逻辑回归模型构建一个预测性计算机软件程序。
本研究的201例患者中，104例（51.7%）疾病复发。多因素分析显示，LKB-1低表达、高危组织病理学和晚期肿瘤-淋巴结-转移（TNM）分期是与复发风险增加、RFS差和OS差相关的独立因素。若将LKB-1表达缺失作为参照类别，则与复发独立相关的因素为LKB-1低表达（比值比[OR]，0.157；95%置信区间[CI]，0.044-0.557）、中度表达（OR，0.073；95%CI，0.017-0.319）和高表达（OR，0.047；95%CI，0.007-0.304）。该模型允许构建一个能够通过受试者工作特征分析进行预测的计算机软件程序（曲线下面积，0.925），并导致定义了具有生物学梯度的五个预后组。
这些结果表明，SCCOC患者中LKB-1表达具有强大的预后价值，并补充了TNM分期系统。所提出的模型需要在前瞻性观察性研究中进行外部验证。
