CXCR 4CD44 CD133表达在舌鳞状细胞癌患者生存分析中的价值

Survival analysis of tongue squamous cell carcinoma with CXCR4, CD44 and CD133 expression

目的:探讨影响舌鳞状细胞癌患者术后生存的相关因素。方法:回顾性分析经病理确诊并行手术治疗的44例舌鳞癌患者临床资料,采用免疫组织化学方法检测不同病理分级舌鳞癌患者癌组织中CXCR4、CD44、CD133的表达情况。将可能影响患者术后生存的指标进行Kaplan-Meier检验后,采用Cox比例风险回归模型进行多因素分析。结果:本研究44例舌鳞癌标本中,高分化29例,中、低分化15例;Ⅰ期11例,Ⅱ期12例,Ⅲ期8例,Ⅳ期13例。各病理分级病例CXCR4、CD44、CD133阳阳性率分别是79.54%(35/44)、77.27%(34/44)和75.00%(33/44)。CXCR4、CD44、CD133在舌鳞癌各病理分级组在之间表达强度差异均有统计学意义(P<0.05),且CXCR4、CD44、CD133分别与转移、复发也成正相关。Cox模型多因素分析提示:CXCR4表达情况、临床分期、颈部转移为本组舌鳞癌患者预后独立的影响因素及死亡的危险因素。结论:CXCR4、CD44、CD133的表达与舌鳞癌的恶性程度存在相关性,CXCR4表达情况、临床分期、颈部转移为术后评价舌鳞癌患者生存的重要指标。

Objective： This study aimed to analyze the correlation of the expression of CXCR4, CD44, and CD133 proteins with the clinicopathological characteristics of patients to identify the factors affecting the post-operation survival rate of tongue squamous cell carcinomas （TSCCs）. Methods： Clinical data of 44 patients with TSCCs were collected and retrospectively analyzed. The diagno- ses of all cases were pathologically confirmed. CXCR4, CD44, and CD 133 expression in 44 TSCCs patients with different pathological grades was examined immunohistochemically. Survival curves were processed in accordance with the Kaplan-Meier method. The Cox regression model was used for the multivariate analysis of relevant clinical and survival data. Results： Among the 44 examined TSCCs patients, 29 cases were well differentiated and 15 were moderately or poor differentiated; 11 cases were stage I, 12 were stage II, 8 were stage III, and 13 were stage IV. Positive staining of CXCR4, CD44, and CD133 was found in all cases with different degrees. Ac- cording to the pathological tumor grade, the positive rates of CXCR4, CD44, and CD133 expression were 79.54% （35/44 cases）,77.27% （34/44 cases）, and 75.00% （33/44 cases）, respectively. Expression of CXCR4, CD44, and CD 133 significantly differed between different histological grades （P〈0.05）. Correlation analysis indicated that the expression of CXCR4, CD44, and CD133 was positively correlated with the metastasis, recurrence of TSCCs. COX multivariate analysis indicated that CXCR4 expression, clinical stage, and neck metastasis were independent prognostic predictors of TSCCs patients and risk factors of death. Conclusion： CXCR4, CD44, and CD133 may be correlated with the malignancy of TSCCs. CXCR4 expression, clinical stage, cervical lymph node metastasis were the correlated prognosis factors of TSCC patients after operation.