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目的:探讨GDF15表达能否作为局部晚期口腔鳞癌的预后生物标志物,以及预测TPF(多西他赛、顺铂和5-氟尿嘧啶)诱导化疗疗效的生物标志物。方法:以256例局部晚期口腔鳞癌的前瞻性临床试验患者为研究对象,采用免疫组织化学方法,检测患者活检样本中GDF15的表达情况,分析其与TPF诱导化疗的预后关系。采用SPSS18.0软件包对数据进行统计学分析。结果:在具有活检样本的230例口腔鳞癌患者中,低表达GDF15的患者68例,高表达GDF15的患者162例。低表达GDF15的患者具有较好的总生存率(P=0.046)、无病生存率(P=0.0496)、无局部复发生存率(P=0.065)和无远处转移生存率(P=0.017)。高表达GDF15的患者中,临床无颈部淋巴结转移、接受TPF诱导化疗者预后较好,总生存率(P=0.018)、无病生存率(P=0.010)、无局部复发生存率(P=0.042)和无远处转移生存率(P=0.006)显著为高。结论 :GDF15表达可作为局部晚期口腔鳞癌的预后生物标志物,也可作为从TPF诱导化疗生存获益的预测性生物标志物。
Objective: To investigate whether GDF15 expression can be used as a prognostic biomarker for locally advanced oral squamous cell carcinoma and to predict the efficacy of TPT (docetaxel, cisplatin and 5-fluorouracil) induction chemotherapy. Methods: A prospective clinical trial of 256 patients with locally advanced oral squamous cell carcinoma was performed. Immunohistochemistry was used to detect the expression of GDF15 in biopsy samples. The relationship between the expression of GDF15 and the prognosis of TPF induced chemotherapy was analyzed. SPSS18.0 software package for statistical analysis of the data. RESULTS: Of the 230 oral squamous cell carcinoma patients with biopsy samples, 68 were low-expression GDF15 and 162 were highly-expressed GDF15. Patients with low expression of GDF15 had better overall survival (P = 0.046), disease-free survival (P = 0.0496), no local recurrence (P = 0.065) and no distant metastasis . Of the patients with high expression of GDF15, clinical metastasis without neck lymph node metastasis and TPF induction chemotherapy had better prognosis, overall survival (P = 0.018), disease-free survival (P = 0.010) and no local recurrence (P = 0.042) and no distant metastasis (P = 0.006) were significantly higher. CONCLUSIONS: GDF15 expression can be used as a prognostic biomarker for locally advanced oral squamous cell carcinoma and as a predictive biomarker for survival benefit from induction chemotherapy with TPF.