Permanent in vitro growth is associated with poor prognosis in head and neck cancer
Permanent in vitro growth is associated with poor prognosis in head and neck cancer
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DOI：
10.1080/00016480310015209
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发表时间：
2004-03-01
影响因子：
1.4
通讯作者：
Grenman, R
中科院分区：
文献类型：
--
作者：
Pekkola, K;Räikkä, A;Grenman, R
目的：头颈癌在体外生长和形成永久细胞系的倾向各不相同。目前尚不清楚癌症在体外永久生长的患者与癌细胞在体外无法生长的患者的结果是否不同。本研究旨在探讨肿瘤细胞体外生长能力与头颈部肿瘤预后的关系。材料与方法：研究对象为1987-1994年间图尔库大学中心医院收治的30例头颈癌患者，其肿瘤标本在本实验室建立了一个永久性的细胞系。对照组是根据相似的肿瘤定位、TNM状态、组织学分级、年龄、性别和一般情况选择的。来自30名对照患者中的14名患者的肿瘤样本也进行了培养，但没有产生永久的细胞系。中位随访期：研究组54个月，对照组52个月。结果：肿瘤体外生长患者的3年生存率仅为19%，而对照组为68%(p=0.001)。在多变量分析中，癌细胞在体外生长的倾向具有独立的预后价值，与不产生细胞系的癌症相比，相对死亡风险(RR)为1.95(95%可信区间1.11-3.42)。在检测的其他因素中，只有原发肿瘤的大小(RR 1.75；95%CI 0.97-3.16)和确诊时的血液血红蛋白水平(RR 0.97；95%CI 0.95-1.01)可能与生存率独立相关。结论--结果表明，癌细胞的体外生长能力对头颈部癌症的预后有重要意义，能够在体外条件下存活和生长的癌细胞在体内表现出侵袭性。癌细胞对邻近宿主细胞产生的旁分泌信号的独立性可能会提高癌细胞的存活和体内转移潜能。
Objective-The propensity of head and neck carcinomas to grow in vitro and to form a permanent cell line varies. It is not known whether the outcome of patients whose cancer gives rise to permanent in vitro growth differs from that of patients whose cancer cells fail to grow in vitro. The purpose of this Study was to find out whether tumor cell capability for in vitro growth is associated with prognosis in head and neck cancer.Material and Methods-The study group consisted of 30 patients treated for head and neck cancer at the University Central Hospital of Turku between 1987 and 1994, and whose tumor samples had produced a permanent cell line in our laboratory A control group was selected from patients treated during the same time period and with the same protocols in the same department. The controls were selected on the basis of similar tumor localization, TNM status, histological grade, age, gender and general condition. Tumor samples from 14 of the 30 control patients were also cultured, but did not result in a permanent cell line. The median follow-up time was 54 months in the study group and 52 months in the control group.Results-The 3-year survival rate of the patients whose cancer gave rise to in vitro growth was only 19%, compared to 68% among the controls (p=0.001). In a multivariate analysis the propensity of cancer cells to grow in vitro had independent prognostic value, the relative risk of death (RR) being 1.95 (95% CI 1.11-3.42) when compared to cancers that did not produce a cell line. Of the other factors tested, only the primary tumor size (RR 1.75; 95% CI 0.97-3.16) and the blood hemoglobin level at diagnosis (RR 0.97; 95% CI 0.95-1.01) were possibly independently associated with survival.Conclusions-The results suggest that the capability of cancer cells for in vitro growth has prognostic significance in head and neck cancer, and that cancer cells that are able to survive and grow in in vitro conditions behave aggressively in vivo. The independence of cancer cells from the paracrine signals produced by the neighboring host cells may enhance cancer cell survival and the metastatic potential in vivo.