Jin Y T, Kayser S, Kemp B L, Ordonez N G, Tucker S L, Clayman G L, Goepfert H, Luna M A, Batsakis J G, El-Naggar A K
Department of Pathology, National Chen Kung University Medical Center, Tainan, Taiwan.
Cancer. 1998 Jun 1;82(11):2159-65.
The clinical course of laryngeal squamous cell carcinoma (LSCC) varies considerably among patients. New biologic markers are needed to facilitate the stratification of individual patients within the conventional clinicopathologic stages of LSCC.
Eighty-three LSCCs from an equal number of patients who received at least 10 years of follow-up were investigated for p53, p21WAF1/CIP1, and bcl-2 protein expression by immunohistochemical techniques. The results were correlated with various clinicopathologic parameters, DNA content, and patient outcome by univariate and multivariate statistical analyses.
Stage IV disease, large tumor size (>3 cm), positive lymph node status, extranodal extension, and p53 overexpression (in > 75% of cells) correlated significantly with prognosis in univariate analysis. There was no correlation between patient outcome and age, gender, race, histologic differentiation, or expression of bcl-2 or p21WAF1/CIP1. In multivariate analysis, lymph node status and p53 overexpression were the only factors significantly associated with survival.
High p53 expression and positive lymph node status were independent predictors of the outcomes of patients with LSCC. These factors may assist in prognostication and better classification of patients for treatment.
喉鳞状细胞癌（LSCC）患者的临床病程差异很大。需要新的生物标志物来促进在LSCC传统临床病理分期内对个体患者进行分层。
采用免疫组化技术对83例来自同等数量患者且接受至少10年随访的LSCC进行p53、p21WAF1/CIP1和bcl-2蛋白表达检测。通过单因素和多因素统计分析将结果与各种临床病理参数、DNA含量及患者预后相关联。
在单因素分析中，IV期疾病、肿瘤大尺寸（>3 cm）、阳性淋巴结状态、结外扩展及p53过表达（>75%细胞）与预后显著相关。患者预后与年龄、性别、种族、组织学分化或bcl-2或p21WAF1/CIP1的表达无相关性。在多因素分析中，淋巴结状态和p53过表达是与生存显著相关的唯一因素。
p53高表达和阳性淋巴结状态是LSCC患者预后的独立预测因素。这些因素可能有助于预后评估及对患者进行更好的治疗分类。
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