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目的:研究表皮生长因子受体(epidermalgrowth factorreceptor,EGFR)在晚期声门上型喉鳞癌组织中的表达情况及其与临床各相关因素的关系,探讨EGFR能否作为判断晚期声门上喉鳞癌患者预后的预测性指标。方法:收集我院2004年1月~2008年4月共52例晚期(Ⅲ期、Ⅳ期)声门上型喉鳞癌患者手术后切除的肿瘤组织,应用免疫组化技术检测EGFR表达情况,运用统计学方法,结合临床资料分析其与肿瘤分期、淋巴结转移、病理分化程度、生存率及术后放疗对预后的影响等临床病理特征的关系。结果:EGFR在晚期声门上型喉鳞癌组织中存在阳性表达,阳性表达物质呈棕黄色,表达率为76.92%(40/52),其中过表达率为44.23%。EGFR的表达与晚期声门上型喉鳞癌患者的年龄、性别、吸烟无关,与浸润程度(P=0.005),淋巴结转移数目(P=0.018),TNM分期(P=0.003),病理分化程度(P=0.011)有关。单因素分析得出EGFR表达程度、T、N分期以及病理分化程度是影响无复发生存时间的危险因素(P<0.05),T、N分期、病理分化程度是影响总生存时间的危险因素(P<0.05)。多因素分析显示只有肿瘤浸润程度(T分期)和淋巴结转移(N分期)是影响无复发生存时间和总生存时间的独立预后因素。EGFR的阴性表达组与阳性表达组的3年、5年生存率不具有统计学差异(P>0.05)。结论:EGFR在晚期声门上型喉鳞癌组织中存在过表达,证实了EGFR的过度表达与肿瘤的侵袭、转移相关,检测其表达水平对晚期喉癌的个体化治疗、靶向治疗有重要参考价值。但EGFR尚不能作为晚期声门上型喉鳞癌行手术及术后辅助放疗患者对无复发生存时间和总生存时间的预测指标。
OBJECTIVE: To investigate the expression of epidermal growth factor receptor (EGFR) in the late stage of supraglottic laryngeal squamous cell carcinoma and its relationship with various related factors, and to explore whether EGFR can be used as a method to evaluate the late supraglottic laryngeal squamous cell carcinoma Predictors of prognosis in cancer patients. Methods: Tumor specimens from patients with supraglottic laryngeal squamous cell carcinoma in our hospital from January 2004 to April 2008 were collected. The expression of EGFR was detected by immunohistochemistry. Using statistical methods, combined with clinical data analysis of its relationship with tumor stage, lymph node metastasis, the degree of pathological differentiation, survival rate and prognosis of postoperative radiotherapy and other clinicopathological features. Results: The positive expression of EGFR was found in the late stage of supraglottic laryngeal squamous cell carcinoma. The positive expression rate of EGFR was 76.92% (40/52). The overexpression rate of EGFR was 44.23%. The expression of EGFR was not associated with the age, sex and smoking in patients with advanced supraglottic laryngeal squamous cell carcinoma, but also with the degree of infiltration (P = 0.005), lymph node metastasis (P = 0.018), TNM stage (P = 0.003) (P = 0.011). Univariate analysis showed that the expression of EGFR, T stage and N stage were the risk factors influencing the recurrence-free survival time (P <0.05). The T stage and N stage were the risk factors affecting the overall survival time (P <0.05). Multivariate analysis showed that only the degree of tumor invasion (T stage) and lymph node metastasis (N stage) were independent predictors of recurrence-free survival and overall survival. The 3-year and 5-year survival rates of EGFR negative expression group and positive expression group were not statistically different (P> 0.05). Conclusion: Overexpression of EGFR in late stage of supraglottic laryngeal squamous cell carcinoma confirms that overexpression of EGFR correlates with tumor invasion and metastasis. It is important to detect the expression of EGFR in individualized and targeted therapy for advanced laryngeal cancer Reference value. However, EGFR can not be used as a predictor of recurrence-free survival and overall survival in patients with advanced supraglottic laryngeal squamous cell carcinoma and postoperative adjuvant radiotherapy.