Fontana X, Dassonville O, Néri J, Vallicioni J, Santini J, Milano G, Combon P, Lapalus F, Demard F
Department of Nuclear Medicine, Centre Antoine-Lacassagne, Nice, France.
Head Neck. 1993 Sep-Oct;15(5):425-32. doi: 10.1002/hed.2880150510.
Identification of prognostic factors in squamous cell head and neck cancers involves analysis of highly diverse clinical and biological parameters. This study analyzed the prognostic value of clinical variables (age, sex, tumor site, stage) and biologic parameters (squamous cell carcinoma antigen [SCC], serum thymidine kinase activity [TK], fibrin, sedimentation rate [SR]) at the time of diagnosis of squamous cell carcinoma of the head and neck (oral cavity, oropharynx, hypopharynx) in 189 patients. Among the clinical variables investigated, UICC stage III-IV disease (p < .0002), a hypopharyngeal site (p < .02), and age over 60 years (p < .01) were all associated with a poor prognosis. Similarly, analysis of biological blood variables allowed definition of cut-off values above which the prognosis was poor: SCC 2.5 ng/mL (p < .01), fibrin 3.5 g/L (p < .01), TK 7 IU/L (p < .0005), and SR 15 mm per first hour (p < .0000). Cox regression analysis of overall survival identified the UICC stage (p < .000), the SR (p < .001), and serum TK (p < .02) as the main independent prognostic factors. A separate study on a small number of head and neck cancer patients revealed higher TK levels in malignant squamous cell carcinoma tissue than in adjacent healthy tissue.
头颈部鳞状细胞癌预后因素的识别涉及对高度多样的临床和生物学参数的分析。本研究分析了189名头颈部（口腔、口咽、下咽）鳞状细胞癌患者诊断时临床变量（年龄、性别、肿瘤部位、分期）和生物学参数（鳞状细胞癌抗原[SCC]、血清胸苷激酶活性[TK]、纤维蛋白、血沉率[SR]）的预后价值。在所研究的临床变量中，国际抗癌联盟（UICC）III-IV期疾病（p<0.0002）、下咽部位（p<0.02）和60岁以上年龄（p<0.01）均与预后不良相关。同样，对血液生物学变量的分析确定了一些临界值，高于这些临界值预后较差：SCC 2.5 ng/mL（p<0.01）、纤维蛋白3.5 g/L（p<0.01）、TK 7 IU/L（p<0.0005）和SR每小时15 mm（p<0.0000）。对总生存期的Cox回归分析确定UICC分期（p<0.000）、SR（p<0.001）和血清TK（p<0.02）为主要的独立预后因素。一项针对少数头颈部癌患者的单独研究显示，恶性鳞状细胞癌组织中的TK水平高于相邻健康组织。
