Werkmeister R, Brandt B, Joos U
Department of Oral and Maxillofacial Surgery, Universitätsklinik der Westfälischen-Wilhelms-Universität, Münster, Germany.
Am J Surg. 1996 Dec;172(6):681-3. doi: 10.1016/s0002-9610(96)00304-2.
In clinical practice it became clear that conventional prognostic parameters of oral squamous cell carcinomas (OSCC) are of limited value for the prediction of a disease-free survival. The overexpression of erbB oncogenes is of importance for the clinical course of a variety of solid tumors. After discovering amplifications of erbB oncogenes even in OSCC, it was the aim of the present study to clarify the potential of oncogenes as additional prognostic markers.
The amplification of the erbB oncogenes in tumorous tissue of 85 OSCC patients was determined using the double-differential polymerase chain reaction. Histologically healthy mucosa in these patients was also studied. In univariate analysis the amplification of erbB oncogenes with clinical and histopathological prognostic parameters was compared.
No significant correlation between common prognostic parameters and erbB-2 amplification was found. Patients whose OSCC tissue showed an average gene copy number for erbB-2 of greater than 1.2, for erbB-3 below 0.11, and a ratio of erbB-1 and erbB-2 below 0.31 had a statistically significant decrease in disease-free survival. Even in histologically healthy oral mucosa from tumor patients an amplification of erbB oncogenes was found.
ErbB oncogene amplifications in oral squamous cell carcinomas play a significant role as a prognostic factor and seem to be effective in predicting decrease in disease-free survival. Genetic abnormalities in tumor-surrounding tissue support the field cancerization hypothesis.
在临床实践中,很明显口腔鳞状细胞癌(OSCC)的传统预后参数对预测无病生存期的价值有限。erbB癌基因的过表达对多种实体瘤的临床进程具有重要意义。在发现即使在OSCC中也存在erbB癌基因扩增后,本研究的目的是阐明癌基因作为额外预后标志物的潜力。
使用双差异聚合酶链反应测定85例OSCC患者肿瘤组织中erbB癌基因的扩增情况。还对这些患者的组织学健康黏膜进行了研究。在单因素分析中,比较了erbB癌基因扩增与临床和组织病理学预后参数。
未发现常见预后参数与erbB-2扩增之间存在显著相关性。OSCC组织中erbB-2平均基因拷贝数大于1.2、erbB-3低于0.11且erbB-1与erbB-2之比低于0.31的患者,其无病生存期有统计学意义的下降。即使在肿瘤患者组织学健康的口腔黏膜中也发现了erbB癌基因的扩增。
口腔鳞状细胞癌中erbB癌基因扩增作为预后因素发挥着重要作用,似乎能有效预测无病生存期的降低。肿瘤周围组织的基因异常支持了场癌化假说。