Molecular detection of minimal residual cancer in surgical margins of head and neck cancer patients.
Molecular detection of minimal residual cancer in surgical margins of head and neck cancer patients.
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在头颈癌患者的手术边缘中最小残留癌的分子检测。
DOI：
10.3233/clo-2009-0474
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Brakenhoff RH
中科院分区：
文献类型：
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作者：
Graveland AP;de Maaker M;Braakhuis BJ;de Bree R;Eerenstein SE;Bloemena E;Leemans CR;Brakenhoff RH
头颈癌手术中一个非常令人失望的情况是，10-30%的头颈鳞状细胞癌（HNSCC）患者尽管在组织病理学上没有肿瘤，但仍会发生局部复发。这些复发是由微小残留癌（MRC）或肿瘤切除后残留的癌前病变引起的。区分MRC和瘤前病变对于更充分地定制术后放疗是重要的。在这里，我们研究了定量逆转录聚合酶链反应（qRT-PCR）的适用性，使用人Ly-6D （hLy-6D）转录物作为分子标记来检测手术边缘的MRC。本研究收集了18例非癌对照患者和67例恶性鳞癌患者的深部手术缘粘膜下样本，其中8例手术缘肿瘤阳性。采用hLy-6D qRT-PCR对样本进行分析，并将数据与临床组织学参数进行对比分析。组织病理学肿瘤阳性手术切缘组与非癌对照组（p < 0.001）和组织病理学无肿瘤切缘组（p = 0.001）差异有统计学意义。本研究提出了一种新的方法来分析头颈癌手术深部切缘。该方法在HNSCC患者深缘中检测MRC的初步数据是有希望的。
A great disappointment in head and neck cancer surgery is that 10–30% of head and neck squamous cell carcinoma (HNSCC) patients develop local recurrences despite histopathologically tumor-free surgical margins. These recurrences result from either minimal residual cancer (MRC) or preneoplastic lesions that remain behind after tumor resection. Distinguishing MRC from preneoplasic lesions is important to tailor postoperative radiotherapy more adequately. Here we investigated the suitability of quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) using human Ly-6D (hLy-6D) transcripts as molecular marker to detect MRC in surgical margins. Submucosal samples of deep surgical margins were collected from 18 non-cancer control patients and 67 HNSCC patients of whom eight had tumor-positive surgical margins. The samples were analyzed with hLy-6D qRT-PCR, and the data were analyzed in relation to the clinicohistological parameters. A significant difference was shown between the group of patients with histopathological tumor-positive surgical margins and the non-cancer control group (p < 0.001), and the group of patients with histopathological tumor-free surgical margins (p = 0.001). This study shows a novel approach for molecular analysis of deep surgical margins in head and neck cancer surgery. The preliminary data of this approach for detection of MRC in deep margins of HNSCC patients are promising.