Microvessel density in advanced head and neck squamous cell carcinoma before and after chemotherapy.
Microvessel density in advanced head and neck squamous cell carcinoma before and after chemotherapy.
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发表时间：
2002-05
影响因子：
2
通讯作者：
F. Dunphy;B. Stack;J. Boyd;T. Dunleavy;H. Kim;C. Dunphy
中科院分区：
文献类型：
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作者：
F. Dunphy;B. Stack;J. Boyd;T. Dunleavy;H. Kim;C. Dunphy
目的研究头颈部鳞状细胞癌(HNSCC)中肿瘤血管生成与预后的关系，目前尚无定论。为了确定晚期(III期和IV期)HNSCC肿瘤内的微血管密度(MVD)是否对肿瘤对2-3个疗程的紫杉醇(紫杉醇)和卡铂的反应有任何影响，我们前瞻性地研究了来自以前未治疗的晚期HNSCC患者的化疗前标本。我们还试图研究化疗后残留的肿瘤，以确定肿瘤内的微血管是否发生了变化。研究设计采用Q-Bend10(CD34)免疫组织化学方法检测肿瘤内的微血管密度。每个肿瘤的“热点”区域(即，血液新生血管最强烈的区域)被考虑进行评估。结果被表示为在5-400x显微镜视野中发现的微血管的平均数量(即，在5-400x显微镜视野中计数的微血管数量除以5)。设置大专院校医学中心。干预紫杉醇和卡铂联合化疗2~3个疗程。结果32例HNSCC患者化疗前肿瘤MVD范围为4.0~39.0(平均14.8；中位数14.2)。32名患者中有8名在病理上完全缓解；他们的肿瘤微血管密度平均为10.9。剩下的24名患者在化疗后有经病理证实的肿瘤残留；他们的肿瘤微血管密度平均为16.5。结论统计分析没有证据表明缓解与MVD和或Lt；16.5之间存在联系。肿瘤微血管密度与总体或无进展生存期无关。在15名患者中，化疗后标本中也有肿瘤MVD结果。化疗前后肿瘤微血管密度差异越大，患者总生存期和无进展生存期越短(p=0.042)。
OBJECTIVE Studies of tumor angiogenesis in head and neck squamous cell carcinoma (HNSCC) in regard to correlation with prognostic significance have yielded inconclusive results. To determine whether the microvessel density (MVD) within the tumor of advanced (Stages III and IV) HNSCC has any impact on tumor response to 2-3 courses of paclitaxel (Taxol) and carboplatin, we prospectively studied pre-chemotherapy specimens from patients with previously untreated, advanced stage HNSCC. We also attempted to study residual tumors after chemotherapy to determine if the MVD within the tumor had changed. STUDY DESIGN The MVD within the tumor was obtained by immunohistochemical staining of the tumors with Q-Bend 10 (CD34). The "hot-spot" areas of each tumor (ie., areas with most intense blood neovascularization) were considered for evaluation. Results were expressed as the Average number of microvessels identified in 5-400x microscope fields (ie., the number of microvessels counted in 5-400x microscope fields divided by 5). SETTING Tertiary University Medical Center. INTERVENTION Two to 3 courses of chemotherapy with paclitaxel and carboplatin. MAIN OUTCOME MEASURES Progression-free and overall survival with 5 years follow-up, RESULTS The tumoral MVD in 32 HNSCC specimens before chemotherapy ranged from 4.0-39.0 (mean, 14.8; median, 14.2). Eight out of 32 patients achieved pathologically complete remission; their tumoral MVD revealed a mean of 10.9. The 24 remaining patients had pathologically-confirmed residual tumor post-chemotherapy; their tumoral MVD revealed a mean of 16.5. CONCLUSION Statistical analyses revealed no evidence of a relationship between remission and a MVD > or or < 16.5. There was no correlation of tumoral MVD with overall or progression-free survival. In 15 patients, tumoral MVD results were also available on the post-chemotherapy specimens. The greater the difference of the tumoral MVD between the pre- and post-chemotherapy specimens, the shorter the patients overall and progression-free survival (p = 0.042).