Williams J K, Carlson G W, Cohen C, Derose P B, Hunter S, Jurkiewicz M J
Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Am J Surg. 1994 Nov;168(5):373-80. doi: 10.1016/s0002-9610(05)80079-0.
Lymph-node metastasis is the single greatest predictor of survival in patients with oral cavity cancers. Tumor angiogenesis has been correlated with metastasis in breast cancer and may have prognostic value in other tumors.
Sixty-six patients with clinically node-negative oral cavity squamous cell cancers were reviewed. Samples were cut and stained for factor VIII. The percentage of area of tissue stained for factor VIII was quantitated by a computerized image analyzer. Tumor depth was measured with an ocular micrometer to the nearest 0.1 mm. Variables were statistically examined against regional recurrence.
The probability of metastasis (%) was 2 for tumor staining of < or = 10% and 93 for tumor staining > 10% (P < 0.0001). The tumor depth was < or = 4 mm in 10 and > 4 mm in 83 (P < 0.0001). Patients with < or = 4 mm and < or = 10% staining had a 2% rate of recurrence, and patients with > 4 mm and > 10% staining had a 100% rate of recurrence (P < 0.0001).
Although tumor thickness was suggestive of predictability, only angiogenesis was a statistically significant predictor of recurrence in a multivariate analysis (P < 0.0001). Angiogenesis showed a strong correlation with regional recurrence and may be used as an independent prognostic indicator.
淋巴结转移是口腔癌患者生存的唯一最大预测因素。肿瘤血管生成与乳腺癌转移相关，可能对其他肿瘤具有预后价值。
回顾了66例临床淋巴结阴性的口腔鳞状细胞癌患者。切取样本并进行因子VIII染色。用计算机图像分析仪对因子VIII染色的组织面积百分比进行定量分析。用目镜测微计测量肿瘤深度，精确到最接近的0.1毫米。对各变量与区域复发情况进行统计学检验。
肿瘤染色≤10%时转移概率（%）为2，肿瘤染色>10%时转移概率为93（P<0.0001）。肿瘤深度≤4毫米的有10例，>4毫米的有83例（P<0.0001）。肿瘤深度≤4毫米且染色≤10%的患者复发率为2%，肿瘤深度>4毫米且染色>10%的患者复发率为100%（P<0.0001）。
虽然肿瘤厚度提示具有可预测性，但在多变量分析中，只有血管生成是复发的统计学显著预测因素（P<0.0001）。血管生成与区域复发显示出强烈相关性，可作为独立的预后指标。
