Leedy D A, Trune D R, Kronz J D, Weidner N, Cohen J I
Department of Otolaryngology, Head and Neck Surgery, Oregon Health Sciences University, Portland 97201.
Otolaryngol Head Neck Surg. 1994 Oct;111(4):417-22. doi: 10.1177/019459989411100405.
A more accurate method of detecting nodal disease in squamous cell carcinoma of the tongue is needed so that treatment of the neck with its associated morbidity can safely be reserved for patients who actually have metastatic disease. Tumor angiogenesis and the expression of the p53 antigen--which have each been shown to be predictive of metastasis in breast and colon cancer, respectively--are examined for their ability to predict neck metastasis in tongue cancer. Fifty-seven patients with T1 and T2 squamous cell carcinoma of the oral tongue, whose neck disease was examined by dissection or by 2-year follow-up, were studied. Twenty-eight patients (49%) were node positive and 29 patients (51%) were node negative. The primary tumors were immunohistochemically stained for the p53 antigen and for factor VIII, which allowed the blood vessels within the tumor to be quantitated. The mean vessel counts per x200 high-power field were 59.8 and 61.5 for node-positive and node-negative patients, respectively (p = 0.8). Node-positive patients showed overexpression of p53 43% of the time, vs. 61% for node-negative patients (p = 0.17). Multivariate analysis confirmed that no difference in tumor angiogenesis or the expression of the p53 antigen was found between tumors that had metastasized and those that had not. Therefore neither tumor angiogenesis nor the p53 tumor marker is clinically useful in determining lymph node metastasis in these patients.
需要一种更准确的方法来检测舌鳞状细胞癌中的淋巴结疾病，以便能将与颈部治疗相关的发病率风险，安全地保留给那些实际患有转移性疾病的患者。肿瘤血管生成和p53抗原的表达——分别已被证明可预测乳腺癌和结肠癌的转移——被研究其预测舌癌颈部转移的能力。对57例口腔舌部T1和T2期鳞状细胞癌患者进行了研究，这些患者的颈部疾病通过解剖或2年随访进行检查。28例患者（49%）淋巴结阳性，29例患者（51%）淋巴结阴性。对原发性肿瘤进行免疫组织化学染色检测p53抗原和因子VIII，这使得肿瘤内的血管得以定量。淋巴结阳性和阴性患者每200个高倍视野的平均血管计数分别为59.8和61.5（p = 0.8）。淋巴结阳性患者中43%的时间显示p53过表达，而淋巴结阴性患者为61%（p = 0.17）。多变量分析证实，已发生转移和未发生转移的肿瘤之间，在肿瘤血管生成或p53抗原表达方面未发现差异。因此，肿瘤血管生成和p53肿瘤标志物在确定这些患者的淋巴结转移方面，在临床上均无用处。
