声门上喉鳞癌组织中诱导型一氧化氮合酶和碱性成纤维细胞生长因子表达与预后的关系

Inducible Nitric Oxide Synthase and Basic Fibroblast Growth Factor Expression as Prognostic Factors in Supraglottic Squamous Cell Carcinoma

背景与目的:声门上喉鳞癌的预后较差,大量研究显示其预后与多种因素有关,但诱导型一氧化氮合酶(induciblenitricoxidesynthase,iNOS)和碱性成纤维细胞生长因子(basicfibroblastgrowthfactor,bFGF)表达与其预后的研究未见报道。本研究旨在探讨iNOS和bFGF表达在判断声门上喉鳞癌预后中的价值。方法:用LSAB法结合病理图像分析系统对64例声门上喉鳞癌组织中iNOS和bFGF蛋白的表达进行检测,研究二者与颈淋巴结转移、肿瘤复发和预后的关系。结果:(1)颈淋巴结阳性者iNOS和bFGF蛋白表达的阳性目标值分别为33.2±8.8和36.1±7.8,明显高于颈淋巴结阴性组的27.3±7.4和24.5±7.5;术后复发者iNOS和bFGF蛋白阳性目标值分别为36.9±1.7和34.6±2.0,高于无复发者的29.1±1.3和27.2±1.4,差异均有统计学意义(P<0.05)。(2)颈淋巴结阳性者的5年生存率低于阴性者(31.0%vs57.1%)。iNOS蛋白阳性表达者的5年生存率低于阴性表达者(40.0%vs77.8%),bFGF蛋白阳性表达者与阴性表达者间5年生存率的差异无统计学意义(P>0.05)。(3)Cox模型多因素回归分析显示,颈淋巴结转移、iNOS蛋白表达和术后放疗对生存的影响有统计学意义,T分期和bFGF蛋白表达不是独立的预后因素。结论:iNOS蛋白表达是独立的预后因素,但iNOS和bFGF表达对声门上喉鳞癌?

BACKGROUND &OBJECTIVE:The prog nosis of suprag lottic squamous cell carcinoma (SGSCC)was poor.To authorsknowledg e,the relationship between inducible nit ric oxide synthase(iNOS )and basic fibroblast g rowth factor (bFGF )and the prog nosis of SGSCC has not bee n addressed to date.This study was desig ned to eval uate the prog nostic sig nificance of these two parameters in SGSCC.METHODS :The expression of iNOS and bFGF protein in 64patients with SGSCC usi ng LSAB method and patholog ic imag in e analysis system and their association with neck lymph node metastases ,recurrence,and prog nosis.RESULTS :(1)The expression of iNOS and bFGF was sig nificantly hig her in cervica l lymph node positive g roup(33.2±8.8and36.1±7.8)than in neg ative g roup(27.3±7.4and 24.5±7.5)with statistical sig nificance.The expression of iNO S and bFGF was hig her in recurrence g r oup(36.9±1.7and 34.6±2.0)than in no-recurrence g roup(29.1±1.3and27.2±1.4)with statistical sig nificance.(2)Patients with positive neck lymph node had poorer 5-year survival than those with neg ative neck lymph node (31.0%vs.57.1%).Patients with positive iNOS expres sion had poorer 5-year survival than those with the neg ativ e iNOS expression(40.0%vs.77.8%).However,there was no statistical si g nificance between positive bFGF expression g roup and neg ative bFGF expression g roup.(3)Cox model multivariate reg ression analysis showed that lym ph node status,the expression of iNO S and postoperative radiotherapy were in dependent prog nosis factors ,where as the T stag ing and the expression of bFGF we re not.CONCLUSION:The expression of iNOS was one of the independent prog nostic factors ,but it is necessary to study further for iNOS and bFGF to predict t he prog nosis of patients with SGSCC u sing immunohistochemical technique.