Altered antigen expression predicts outcome in squamous cell carcinoma of the head and neck.
Altered antigen expression predicts outcome in squamous cell carcinoma of the head and neck.
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DOI：
10.1093/jnci/82.19.1566
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发表时间：
1990-10
期刊：
影响因子：
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通讯作者：
G. Wolf;T. Carey;S. Schmaltz;K. Mcclatchey;J. Poore;Lynda Glaser;D. Hayashida;Sandra Hsu
中科院分区：
文献类型：
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作者：
G. Wolf;T. Carey;S. Schmaltz;K. Mcclatchey;J. Poore;Lynda Glaser;D. Hayashida;Sandra Hsu
单克隆抗体UM-A9鉴定了在上皮细胞基底表面发现的抗原，并在我们所测试的所有鳞状细胞癌（SCC）中表达。在之前的研究中，我们发现来自转移性或复发性SCC的细胞系比来自同一供体原发肿瘤的细胞系表现出更强的A9细胞膜抗原表达，这表明该标志物与肿瘤进展有关。正常A、B和H （ABH）血型抗原在肿瘤组织中的表达缺失也与一些上皮性癌症的临床行为有关。为了确定这些抗原标记物的预后意义，我们前瞻性地评估了82例连续未经治疗的头颈部鳞状细胞癌患者的组织标本中这些标记物的表达。观察到A9抗原强表达（模式1）、中表达（模式2）和弱表达（模式3）三种模式。A9抗原表达模式1的患者中有58%，血型抗原丢失的患者中有78%的患者早期复发，而A9抗原表达模式2或3的患者中只有34% (P = 0.042)，肿瘤表达成熟ABH血型抗原的患者中只有37% （P = 0.012）。即使在调整了肿瘤部位、分期和TNM分类等传统预后因素后，肿瘤组织中A9型和ABH血型抗原表达的结合是与无病生存时间最密切相关的变量。血型缺失是与早期复发相关的最重要的单一变量，但在肿瘤保留ABH血型抗原表达的患者中，A9模式区分预后良好和预后不良组。据我们所知，我们的研究首次证明了血型抗原表达的差异与头颈部鳞状细胞癌的无病生存率显著相关。我们已经启动了一项研究(a)确定A9抗原和血型抗原与肿瘤临床反应的关系，(b)确定这些标记物是否应该用作预后指标。
Monoclonal antibody UM-A9 identifies an antigen found on the basal surface of epithelial cells and expressed on all of the squamous cell carcinomas (SCC) that we have tested. In a previous study, we showed that cell lines from metastatic or recurrent SCC exhibit stronger expression of the A9 cell membrane antigen than cell lines from the primary tumor of the same donors, suggesting that this marker is associated with tumor progression. Loss of expression in tumor tissue of normal A, B, and H (ABH) blood group antigens has also been linked to clinical behavior in some epithelial cancers. To determine the prognostic significance of these antigen markers, we prospectively evaluated tissue specimens for expression of these markers in a group of 82 consecutive, previously untreated patients with SCC of the head and neck. Three patterns corresponding to strong (pattern 1), intermediate (pattern 2), or weak (pattern 3) A9 antigen expression were observed. Fifty-eight percent of the patients whose tumors had pattern 1 A9 antigen expression and 78% of the patients with loss of blood group antigen had early relapse, compared with only 34% of those with A9 antigen pattern 2 or 3 (P = .042) and 37% of those whose tumors expressed the mature ABH blood group antigen (P = .012). The combination of A9 pattern and ABH blood group antigen expression in tumor tissue was the variable most strongly associated with duration of disease-free survival, even after adjustment for the traditional prognostic factors of tumor site, stage, and TNM classification. Loss of blood group was the most significant single variable associated with early recurrence, but among patients whose tumors retained ABH blood group antigen expression, the A9 pattern distinguished good and poor prognostic groups. To our knowledge, our study is the first to demonstrate that differences in blood group antigen expression are significantly correlated with disease-free survival in SCC of the head and neck. We have initiated a study (a) to determine the relationship of the A9 antigen and the blood group antigens with clinical response of the tumors and (b) to determine whether these markers should be used as prognostic indicators.