Preoperative SCC Antigen, CRP Serum Levels, and Lymph Node Density in Oral Squamous Cell Carcinoma.
Preoperative SCC Antigen, CRP Serum Levels, and Lymph Node Density in Oral Squamous Cell Carcinoma.
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DOI：
10.1097/md.0000000000003149
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发表时间：
2016-04
期刊：
影响因子：
1.6
通讯作者：
Huang SF
中科院分区：
文献类型：
--
作者：
Adel M;Tsao CK;Wei FC;Chien HT;Lai CH;Liao CT;Wang HM;Fan KH;Kang CJ;Chang JT;Huang SF
口腔鳞状细胞癌（OSCC）中鳞状细胞癌抗原（SCC-Ag）和C反应蛋白（CRP）水平以及淋巴结密度（LND）的预后意义已被单独认识。本研究旨在探讨术前血清标志物（SCC-Ag和CRP）与术后预后标志物（LND）之间的关系。我们回顾性分析了2008年3月至2013年11月期间接受原发性根治性切除术和颈淋巴结清扫术伴/或不伴辅助治疗的277例OSCC患者。术前测定血清SCC-Ag和CRP水平。采用远处转移、总生存期（OS）和无病生存期（DFS）评价术前SCC-Ag和CRP水平与LND的预后意义。LND（临界点≥0.06）与肿瘤病理状态、病理淋巴结转移、分化程度、肿瘤分期、肿瘤深度（≥10 mm vs <10 mm）、神经浸润有关（P均<0.001）。 LND与远处转移、无病生存率和总生存率显著相关（P均<0.001）。术前CRP和SCC-Ag水平升高与LND（P = 0.006）、DFS（P <0.001）和OS（P <0.001）显著相关。 根据SCC-Ag和CRP水平将LND+患者进一步分为预后组（DFS：P = 0.010; OS：P = 0.003）。 LND与OSCC患者DM、DFS和OS的发生率相关。同时术前SCC-Ag和CRP水平升高是LND的预测因子。此外，SCC-Ag和CRP是将高风险LND+ OSCC患者分为亚组的标志物。
Supplemental Digital Content is available in the text The prognostic significance of squamous cell carcinoma antigen (SCC-Ag) and C-reactive protein (CRP) levels and lymph node density (LND) has been individually recognized in oral squamous cell carcinoma (OSCC). We investigated the relationship between preoperative serum markers (SCC-Ag and CRP) and postoperative prognostic marker (LND) in this study. We retrospectively analyzed 277 OSCC patients who underwent primary curative resection and neck dissection with/or without adjuvant therapy between March 2008 and November 2013. Serum SCC-Ag and CRP levels were measured preoperatively. Distant metastasis, overall survival (OS), and disease-free survival (DFS) were used to evaluate the prognostic significance of preoperative SCC-Ag and CRP levels in relation to LND. LND (cutoff point ≥0.06) correlated with the pathologic tumor status, pathologic nodal metastasis, degree of differentiation, tumor stage, tumor depth (≥10 mm vs <10 mm), and perineural invasion (all P values were <0.001). LND was significantly associated with development of distant metastasis, DFS, and OS (all P values were <0.001). Preoperative elevated CRP and SCC-Ag levels were significantly associated with LND (P = 0.006), DFS (P < 0.001), and OS (P < 0.001). LND+ patients were further stratified into prognostic groups according to their SCC-Ag and CRP levels (DFS: P = 0.010; OS: P = 0.003). LND correlated with the incidence of DM, DFS, and OS in patients with OSCC. Concurrent elevated preoperative SCC-Ag and CRP levels are predictors for LND. In addition, SCC-Ag and CRP are markers for classifying high-risk LND+ patients with OSCC into subgroups.