口腔扁平上皮癌の悪性度評点と予後因子 MALIGNANCY SCORE AND PROGNOSTIC FACTOR IN PATIENTS WITH ORAL SQUAMOUS CELL CARCINOMA

この論文にアクセスする

この論文をさがす

著者

抄録

外科療法を行った口腔扁平上皮癌509例を対象に, 悪性度評点 (Malignancy score: MS) の臨床的意義を明らかにする目的で検討を行った。MSは生検の組織学的所見 (分化度, 分裂指数, 細胞異型度, 癌浸潤様式, 単核細胞浸潤) に基づき決定した。病因特異的5年累積生存率は, MS5-9点の低悪性では90%以上, MS10-12点の中悪性では67-78%、MS13-16点の高悪性では40-57%であった。多変量解析にて, T, N, MSは独立した予後因子であった。stage III, IVの85例についてp53と bax の発現を免疫組織化学的に検討した。低悪性および中悪性では予後は比較的良好であったが, p53(+) bax (-)では不良で, 高悪性では, p53の発現に関わらず bax (-)では不良であった。P53, bax などのバイオファンクショナルマーカーを患者個人にみあった治療方針に反映させることを考える場合には, 組織学的悪性度と併せて評価を行うことの必要性が示唆された。

To assess the clinical significance of malignancy score (MS), 509 patients with oral squamous cell carcinoma (oral SCC) submitted to surgery were reviewed. The MS was determined based on 5 conventional histologic findings from initial biopsy specimens: 1) differentiation, 2) mitotic index, 3) cell atypism, 4) mode of cancer invasion, and 5) mononuclear cell infiltration. Five-year cause-specific survival rates by the MS were 90% or more in patients with low malignancy (MS, 5-9), 67-78% in patients with moderate malignancy (MS, 10-12), and 40-57% in patients with high malignancy (MS, 13-16). T, N, and the MS were chosen as independent prognostic factors multivariate analysis. These results imply that conventional histologic findings have a crucial role in determining the surgical practice for oral SCC as well as the clinical stage.<br>p53 and bax expression in 85 patients with stage III and IV were immunohistochemically investigated using antibody DO7 and antibody against bax. p53 expression had a negative impact on survival, while bax expression was associated with a good prognosis. The survival rate for patients with low or moderate malignancy was relatively good, but among these patients, those with p53 (+) bax (-) was worse. The survival rate for patients with bax (-) among patients with high malignancy was extremely poor regardless of p53 expression. When utilizing bio-functional markers such as p53 or bax to determine suitable treatment options for individual patients, it is suggested that combined evaluation with the MS is necessary.

収録刊行物

  • 頭頚部腫瘍

    頭頚部腫瘍 29(4), 558-562, 2003-12-25

    Japan Society for Head and Neck Cancer

参考文献:  19件中 1-19件 を表示

被引用文献:  2件中 1-2件 を表示

各種コード

  • NII論文ID(NAID)
    10012172726
  • NII書誌ID(NCID)
    AN00165234
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    09114335
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
ページトップへ