口腔鳞状细胞癌组织中HPV感染及EGFR、Sox2蛋白表达与肿瘤预后的相关性

Correlation between HPV infection and EGFR,Sox2 expression with prognosis in oral squamous cell carcinoma

目的探讨口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)组织中人乳头状瘤病毒(human papiloma virus,HPV)感染及EGFR、Sox2表达与肿瘤复发的关系。方法收集OSCC组织标本85例,分别采用PCR-DNA反向点杂交及免疫组化SP法检测蜡块组织中HPV感染及EGFR、Sox2表达,收集患者病理资料并进行随访。结果 HPV在OSCC组织中的检出率为29.4%(25/85),阳性患者以非吸烟者居多,高于阴性患者(P<0.001)。HPV感染与患者性别、年龄、肿瘤部位、临床分期、分级及淋巴结转移无明显相关性(P>0.05);EGFR、Sox2的阳性率分别为69.4%(59/85)、71.8%(61/85);EGFR表达与肿瘤分化程度有关(P<0.001);Sox2表达与肿瘤分化程度及TNM分期有关(P<0.001、P<0.009)。随访2年以上的OSCC患者中17例出现复发(复发组),HPV阳性患者治疗后复发率为5.9%(1/17),低于HPV阴性患者(P=0.037);EGFR、Sox2蛋白在复发组和未复发组中阳性率分别为88.2%、94.1%及64.7%、66.2%;Sox2蛋白在复发组中的阳性率明显高于未复发组(P=0.047)。结论 OSCC中存在一定比例的HPV感染及EGFR、Sox2表达;HPV阳性患者复发率低于阴性患者;EGFR表达与肿瘤分级有关;Sox2表达与肿瘤分级、TNM分期及复发相关。HPV阴性、EGFR及Sox2阳性患者治疗后应定期随诊。

Purpose To detect the infection of human papillomavirus （HPV） and EGFR, Sox2 expression in oral squamous cell carcinoma tissues and their correlation with tumor recurrence. Methods Totally 85 cases of oral squamous cell carcinoma specimens were selected, PCR-DNA reverse dot blot hybridization was used to detect the infection of HPV and SP immunohistochemical method was adopted to detect the expression of EGFR, Sox2 proteins in paraffin wax blocks. Clinical data were collected and all patients were followed up. Results The infection rate of HPV in oral squamous cell carcinoma was 29. 4% （25/85）. HPV-positive cases, mostly in non-smokers, significantly higher than smokers （P 〈 0. 001 ）. HPV infection was not significantly correlated with patients＇ gender, age, tumor location, clinical stage, differentiation and lymph node metastasis （P 〉 0. 05）. The expression rate of EGFR and Sox2 was 69. 4% （ 59/85 ） and 71.8% （ 61/85 ） respectively. Expression of EGFR was associated with tumor differentiation （ P 〈 0. 001 ） , while Sox2 was correlated with differentiation and TNM stage of tumor （ P 〈 0. 001, P 〈 0. 009 ）. In the more than two-year follow-up study, 17 cases showed recurrence （ recurrence group）. The recurrence rate of HPV-positive patients was 5.9% （1/17） after treatment, which was lower than that of HPV-negative ones （P = 0. 037）. The expression rates of EGFR, Sox2 protein in the recurrence group and the non-recurrence group were 88. 2% , 94. 1% and 64. 7%, 66. 2% , respectively. The expression rate of Sox2 in recurrent group was significantly higher than that in non-recurrence group （P = 0. 047）. Conclusion There is a certain degree of infection of HPV and EGFR, Sox2 expression in oral squamous cell carcinoma tissues. Patients with HPV infection had lower recurrence rate than that of HPV-negative ones. EGFR expression is correlated with tumors differentiation. Sox2 expression is correlated with tumors grade, stage and differentiation. HPV-negative, EGFR and Sox2 expression positive patients should be regularly followed up.