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標題: | 表現於SiSo細胞之受器結合癌抗原(RCAS1)於口腔癌前病變及口腔癌之表現 Expression of receptor-binding cancer antigen expressed on SiSo cells (RCAS1) in oral precancers and cancers |
作者: | Tung-Chieh Tsai 蔡東潔 |
指導教授: | 江俊斌 |
關鍵字: | 表現於SiSo細胞之受器結合癌抗原(RCAS1),口腔癌,口腔癌前病變, RCAS1,oral cancer,oral dysplasia,prognosis, |
出版年 : | 2007 |
學位: | 碩士 |
摘要: | 背景:過去之研究顯示表現於SiSo細胞之受器結合癌抗原(RCAS1)之過度表現和腫瘤的大小、淋巴結的轉移、臨床或病理的分期、和病人的預後等有統計上有意義的相關。
方法:本研究利用免疫組織化學染色的方法,探討RCAS1於84例口腔鱗狀細胞癌(OSCC),106例口腔上皮變異(OED;32例輕度,44例中度,30例重度上皮變異),和20例正常口腔黏膜(NOM)之表現。 結果:我們發現RCAS1平均標記指數,從正常口腔黏膜之12 ± 5%,至輕度口腔上皮變異之31 ± 13%,中度口腔上皮變異之44 ± 17%,及重度口腔上皮變異之56 ± 18%,至口腔鱗狀細胞之68 ± 20%,有隨著惡性程度的增加而呈現統計學上有意義增加的情形(P < 0.001)。統計分析的結果也顯示,較大的口腔鱗狀細胞癌(P = 0.001)、有局部淋巴結轉移者(P < 0.001)與有較高的臨床分期者(P < 0.001),其RCAS1平均標記指數通常呈統計學上有意義之增高。經過Cox regression model之多變數分析發現,有局部淋巴結轉移(P = 0.0073)及RCAS1 LI ≧ 60%(P = 0.048)為預測不利預後之獨立變相,Kaplan-Meier 曲線分析發現,當口腔鱗狀細胞癌之RCAS1 LI ≧ 60%比其RCAS1 LI < 60%之患者,通常有較差之累積存活率(log-rank test, P = 0.0113)。 結論:我們的結果顯示,RCAS1之表現在口腔癌前病變時期,也就是說口腔上皮變異時期,即有明顯之增加。RCAS1之表現和口腔鱗狀細胞癌患者的腫瘤大小、淋巴結轉移以及臨床分期呈現統計學上有意義之正相關。因此口腔鱗狀細胞的RCAS1之標記指數,可預測台灣口腔鱗狀細胞的進展及預後。 BACKGROUND: Overexpression of receptor-binding cancer antigen expressed on SiSo cells (RCAS1) has been found to be significantly associated with the tumor size, lymph node metastasis, clinical or pathological stage, and prognosis of a variety of human cancers. METHODS: This study examined the expression of RCAS1 in 84 specimens of oral squamous cell carcinoma (OSCC), 106 specimens of oral epithelial dysplasia (OED, 32 mild, 44 moderate, and 30 severe OED cases), and 20 specimens of normal oral mucosa (NOM) by immunohistochemistry. RESULTS: We found that the mean RCAS1 labeling indices (LIs) increased significantly from NOM (12 ± 5%) through mild OED (31 ± 13%), moderate OED (44 ± 17%), and severe OED (56 ± 18%) to OSCC samples (68 ± 20%, P < 0.001). A significant correlation was found between the higher mean RCAS1 and OSCCs with larger tumor size (P = 0.001), positive lymph node metastasis (P < 0.001), or more advanced clinical stages (P < 0.001). Positive lymph node metastasis (P = 0.0073) and RCAS1 LI ≧ 60% (P = 0.048) were identified as independent unfavorable prognosis factor by multivariate analyses with Cox regression model. Kaplan-Meier curve showed that OSCC patients with a RCAS1 LI ≧ 60% had a significantly poorer cumulative survival than those with a RCAS1 LI < 60% (log-rank test, P = 0.0113). CONCLUSIONS: We conclude that the expression of RCAS1 is an early event in oral carcinogenesis. The RCAS1 LI in OSCC samples can predict the progression of OSCCs and the survival of OSCC patients. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28488 |
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