Podoplanin: A novel marker for oral cancer risk in patients with oral premalignancy
Podoplanin: A novel marker for oral cancer risk in patients with oral premalignancy
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DOI：
10.1200/jco.2007.13.4072
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发表时间：
2008-01-20
影响因子：
45.3
通讯作者：
Mao, Li
中科院分区：
文献类型：
--
作者：
Kawaguchi, Hidetoshi;El-Naggar, Adel K.;Mao, Li
目的 口腔白斑 (OPL) 是一种异质性口腔病变，会增加口腔癌的风险。目前的临床参数无法预测 OPL 患者恶变的可能性。我们已经证明，平足蛋白（一种淋巴管内皮标记物）在口腔癌和一些口腔癌前病变中高表达。本研究的目的是确定 Podoplanin 在预测 OPL 患者口腔癌发展中的作用。患者和方法 使用免疫组织化学方法在长期随访的 150 名 OPL 患者中测定 Podoplanin 表达。分析了蛋白表达模式与随访期间口腔癌发展等临床病理参数之间的关联。结果 150 名 OPL 患者中有 56 名 (37%) 在基底层和基底上层表现出足足蛋白表达，并被归类为足足蛋白阳性。 Podoplanin 阳性在老年患者 ( P = .016)、女性 ( P = .020) 和发育不良病变 ( P = .040) 中更为常见。平足蛋白阳性 OPL 患者的口腔癌发病率显着高于平足蛋白阴性 OPL 患者 ( P =.0002)。在使用组织学和 podoplanin 作为辅助因子的多变量分析中，podoplanin 是口腔癌发生的唯一独立因素（风险比 = 3.087；95% CI，1.530 至 6.231；P =.002）。重要的是，通过考虑组织学和足足蛋白信息，可以进一步对口腔癌风险进行分层。结论足足蛋白在 OPL 中频繁表达。与组织学结合，podoplanin 可以作为一种强大的生物标志物来预测 OPL 患者患口腔癌的风险。
Purpose Oral leukoplakia (OPL) is a heterogeneous oral lesion with an increased oral cancer risk. Current clinical parameters cannot predict the potential of malignant transformation in patients with OPL. We have shown that podoplanin, a lymphatic endothelial marker, is highly expressed in oral cancer and some oral premalignancies. The purpose of this study is to determine a role of podoplanin in predicting oral cancer development in patients with OPL.Patients and Methods Podoplanin expression was determined in 150 OPL patients with long-term follow-up using immunohistochemistry. Association between the protein expression patterns and clinicopathologic parameters including oral cancer development during the follow-up were analyzed.Results Fifty-six (37%) of the 150 OPL patients exhibited podoplanin expression in the basal and suprabasal layers and were classified as podoplanin positive. Podoplanin positivity was more frequent in older patients ( P =.016), females ( P =.020), and dysplastic lesions ( P =.040). Patients with OPL that was podoplanin positive had significantly higher incidence of oral cancer than did those whose OPL was podoplanin negative ( P =.0002). In the multivariate analysis using histology and podoplanin as cofactors, podoplanin was the only independent factor for oral cancer development ( hazard ratio = 3.087; 95% CI, 1.530 to 6.231; P =.002). Importantly, oral cancer risk can be further stratified by considering both histology and podoplanin information.Conclusion Podoplanin is frequently expressed in OPL. Together with histology, podoplanin may serve as a powerful biomarker to predict the risk for oral cancer development in patients with OPL.