de Barros Felipe Dubourcq, Torres Leuridan Cavalcante, Araujo Carolline, da Silva Marinho Felipe, Dubourcq Beatriz Cavalcanti, Dubourcq Luís Cavalcanti, Guimarães Gustavo Cardoso
Hospital de Câncer de Pernambuco, Av Cruz Cabuga 1597 Santo Amaro, Recife, Pernambuco, 50040000, Brazil.
Instituto de Medicina Integrada de Pernambuco, Recife, Pernambuco, Brazil.
J Cancer Res Clin Oncol. 2023 May;149(5):2081-2094. doi: 10.1007/s00432-022-04222-8. Epub 2022 Aug 1.
Penile cancer has a high incidence in developing countries. The standard treatment is removal of the primary tumor and, when necessary, inguinal lymphadenectomy. Currently, the most important prognostic factor is lymph node disease, however, the available staging methods are inaccurate, and the high morbidity rate of lymphadenectomy has stimulated the study of predictive biomarkers of lymph node metastasis for selecting the patients who need lymphadenectomy. SOX2, STAT3 and CD44/CD24 were chosen because they have provided good predictive results in other squamous cell carcinoma (SCC), although there are no studies for penile cancer. Thus, the expression of SOX2, STAT3, CD24+, and CD44+ in the penile cancer tumor microenvironment was investigated for correlation with tumor behavior in SCC.
This observational, prospective, translational study included 34 men and investigated the expression of SOX2, STAT3, CD24+, and CD44+ in tumor tissue by flow cytometry.
The median age of the 38 evaluated patients with penile cancer was 61 (37-80) years. Most patients presented a tumor located on the glans penis (82.3%), with the usual histological type (79.4%) and 61.7% of patients presented stage pT2. No metastasis was found in 85.3% of patients. The expression of SOX2, STAT3 and CD44/CD24 in the microenvironment of penile SCC treated with lymphadenectomy was significantly associated with aggressive tumor behavior (p < 0.05). STAT3 expression shows discrepant points when evaluated in context of angiolymphatic vascular invasion.
SOX2, STAT3 and CD44/CD24 in penile SCC can be indicators of prognosis, allowing for selection of more aggressive treatment when necessary.
阴茎癌在发展中国家发病率较高。标准治疗方法是切除原发肿瘤，必要时进行腹股沟淋巴结清扫术。目前，最重要的预后因素是淋巴结疾病，然而，现有的分期方法不准确，淋巴结清扫术的高发病率促使人们对淋巴结转移的预测生物标志物进行研究，以选择需要进行淋巴结清扫术的患者。选择SOX2、STAT3和CD44/CD24是因为它们在其他鳞状细胞癌（SCC）中提供了良好的预测结果，尽管尚无针对阴茎癌的研究。因此，研究了阴茎癌肿瘤微环境中SOX2、STAT3、CD24+和CD44+的表达与SCC肿瘤行为的相关性。
这项观察性、前瞻性、转化性研究纳入了34名男性，通过流式细胞术研究了肿瘤组织中SOX2、STAT3、CD24+和CD44+的表达。
38例接受评估的阴茎癌患者的中位年龄为61岁（37-80岁）。大多数患者的肿瘤位于阴茎头（82.3%），组织学类型常见（79.4%），61.7%的患者为pT2期。85.3%的患者未发现转移。接受淋巴结清扫术的阴茎SCC微环境中SOX2、STAT3和CD44/CD24的表达与侵袭性肿瘤行为显著相关（p<0.05）。在评估血管淋巴管侵犯的情况下，STAT3表达显示出不同的点。
阴茎SCC中的SOX2、STAT3和CD44/CD24可作为预后指标，必要时可用于选择更积极的治疗方法。
