喉鳞状细胞癌患者预后的多因素分析  

Multivariate survival analysis in patient with laryngeal squamous cell carcinomas

作　　者：郭剑锋[1] 陈福进[2] 管志伟[1] 陈艳峰[2] 李秋梨[2] 欧阳电[2] 

机构地区：[1]东莞市人民医院耳鼻咽喉科,广东东莞523018 [2]中山大学肿瘤防治中心头颈科

出　　处：《临床耳鼻咽喉科杂志》2006年第14期636-639,共4页Journal of Clinical Otorhinolaryngology

摘　　要：目的:探讨影响喉鳞状细胞癌患者预后的主要因素。方法:采用免疫组织化学SP法检测79例喉鳞状细胞癌患者肿瘤组织和10例癌旁正常组织中细胞S期激酶相关蛋白(Skp2)、p27、上皮细胞钙黏素(Ecad)、α连环素(αcat)的表达,并对可能影响喉鳞状细胞癌患者预后的12项临床病理因素进行单因素和多因素分析。结果:①Skp2在喉鳞状细胞癌和癌旁正常组织中的表达率分别为53.16%和0,p27分别为30.38%和90.00%,Ecad分别为34.18%和100.00%,αcat分别为40.51%和100.00%,其差异均有统计学意义(P<0.05或P<0.01)。②本组患者总的5年生存率为58.75%,Skp2蛋白低表达组的5年生存率(72.18%)显著高于高表达组(44.17%)(P<0.01);p27蛋白高表达组的5年生存率(72.98%)显著高于低表达组(51.13%)(P<0.01);Ecad及αcat阳性表达组的5年生存率(分别为63.80%和81.74%)显著高于阴性表达组(分别为50.68%和41.09%)(P<0.05和P<0.01)。③单因素分析显示:病理分级,颈淋巴结转移,临床分期,T分期,复发,Skp2、p27、Ecad及αcat表达对患者预后的影响均有统计学意义(P<0.05或P<0.01);多因素分析显示:复发、Skp2及αcat表达为影响患者预后的独立因素(P<0.05或P<0.01)。④Skp2和p27蛋白表达之间存在着负相关关系(P<0.01);p27和αcat蛋白表达之间、Ecad和αcat蛋白表达之间存在正相关关系(均P<0.01)。结论:复发、Skp2及αcat表达为影响喉鳞状细胞癌患者预后的重要因素。Objective：This study was designed to analyze the most important factors affecting the prognosis of the patients with laryngeal squamous cell carcinoma（LSCC）. Method： The expression of S-phase kinase associated protein 2（Skp2） , p27, E-cadherin （E-cad） and α-catenin（α-cat） in 79 cases of LSCC and 10 cases of adjacent normal laryngeal mucosa tissues were evaluated by SP immunohistochemistry methods, 12 clinicopathological factors affecting the prognosis of LSCC were analyzed using univariate model and multivariate regression model. Result：（1） The overexpression rate of Skp2 was significantly higher in LSCC（53.16 %） than in adjacent normal laryngeal mucosa tissue （0%）（ P 〈0.05）. The overexpression rate of p27 was significantly lower in LSCC（30.38%） than in adjacent normal laryngeal mucosa tissue （90 %）（ P 〈0.05）. The positive expression rate of E-cad was significantly lower in LSCC（34.18 % ） than in adjacent normal laryngeal mucosa tissue （100 % ）（ P 〈0.05）. The positive expression rate of α-cat was significantly lower in LSCC（40. 51%） than in adjacent normal laryngeal mucosa tissue （100%）（ P 〈0.05）. （2） There was a significantly higher 5-year survival rate in reduced Skp2 expression group （72.18%）when compared with that of Skp2 overexpression group（44.17%） in LSCC（ P 〈0.01）. There was a significantly higher 5-year survival rate in p27 overexpression group（72. 98%） when compared with that of reduced p27 expression group in LSCC（（51.13%） （ P 〈0.01）. The 5-year survival rates of positive E-cad expression group and positive α-cat expression group in LSCC were 63.80% and 81.74% respectively, the 5-year survival rates of negative E-cad expression group and negative α-cat expression group were 50.68% and 41.09% respectively. There were significantly higher 5-year survival rates in positive expression groups when compared with that of negative expression groups（ P 〈0.05 and P d0.01）. （3）The uni

关 键 词：喉肿瘤 癌 鳞状细胞 SKP2蛋白 上皮细胞钙黏素 α-连环素蛋白 预后 

分 类 号：R739.65[医药卫生—肿瘤]