| BackgroundOral cancer is common malignent tumor and more than 90%of oral cancer is oral squamous cell carcinoma(OSCC). The tumor tends to invade, recurrence and metastasize to neck nodes. Oral tissue is rich in lymphatics, blood vessels, muscle, nearby nerve fibers. All of these are potential sources of metastasis, but its molecular biology mechanism is not well known. Oral squamous cell carcinoma is considered to be the result of a mutilstep process which involves a number of aberrant genetic events. In recent decades, a handful of biomakers frenqently associated with the biological behavior in OSCC were found. Actually, the clinical behavior of OSCC is very difficult to predict using solely conventional clinical and histopathologic parameters, and it is clinically not clear why some patients do better than others with the same stage and site of disease. Therefore, it is clinically important to identify new prognostic characteristics that precisely reflect the biologic behavior of this disease.ObjectionThe aims of this study were to analyse the characteristics about clinicopathologic in a group of oral squamous cell carcinoma patients and to investigate the relationship of some lymphangiogenesis and angiogenesis-associated genes immunoexpression and clinicopathologic factors in oral squamous cell carcinoma.MethodsIn this restospective study we analysed characteristics about clinicopathologic factors of 55 primary OSCC patients operated on in a period between 2001 and 2008 at the Maxillofacial Clinic in the Clinc for Oral and Maxillofacial Surgery of Changzheng Hospital, Second Military Medical University. Clinical groups according to the primary anatomic localization include lip(8), tongue body(15), tongue base(1 1), buccal mucosa(10), gingiva(1 1), and matastasis group(24), non-matastasis (31) according to matastasis before surgery. The follow-up period of the disease was from 5 to 98 months after surgerical treatment and 6 cases were lost,49 cases were effective. In our study, we defined recurrence or neck lymph node metastasis as poor prognosis during the oberservation period. Medical files were analyzed and reviewed to collect information concering age, gender, primary anatomic localization, nodal status, tumoral recurrences, histologic classification. Categorical date was staistically analyzed by chi-square test and the univariate analysis using Kaplan-Meier method and log rank test, and analyses the postsurgical 1 to 5-year recurrence or metastasis rate.1. Immunohistochemical En Vision TM method was used to detect the expression of HlF-1a, VEGF, p53, MDM2, p21 WAF1, Ki-67 proteins. The results were assigned by a mean score (MS) based on the product of the percentage of cells and the intensity of the stain to analyse difference between expressions of genes in primary location, differenciation, neck lymph node metastasis and.prognosis. The expression among different groups was compared by the Mann-Whitney U test and Kruskal-Wallis test or one-way ANOVA.2. Clustering analysis among the 6 genes were analysed by hierachical variables clustering analysis. Correlation among the scores of different stains were clustered in a group, p53, Ki-67 and p21 WAF1 in another group, MDM2 alone in the third group. The correlations between the expression of HIF-1a and VEGF in 55 cases of OSCC (r=0.377, P<0.05) and in poor-differentiatied group, nodal metastasis group, good prognosis group, man group and<55 years old group had statistical significance(P <0.05). Correlations had not found in location group, non-metastasis group, poor-differation group, poor prognosis group, women group,>55 years old group (P>0.05).ConclusionsThe results of this study suggest that neck node metastasis and poor-differation were associated with poor prognosis in OSCC, especially, combined neck nodal metastasis and poor differentiation mean worse clinical outcome (the recurrences or node metastasis rate was 83.3%). The follow-up of neck nodal metastasis and poor differentiation is necessery, especially in 2 year after surgery. Overexpression of combined HIF-1a and VEGF predict poor prognosis, and the mechanism maybe HIF-1a and VEGF involves neck nodal metastasis coorderatelly in OSCC. Meantime overexpression of combined HIF-1a and VEGF was associated with poor-differation. The study suggests overexpression of combined HIF-1a and VEGF maybe as a clinical parameter for the prognosis and disease outcome in OSCC, and further follow-up in the future is necessary. |
