Gene Expression as Predictor of Metastasis in HNSCC

描述（由申请人提供）：头颈部鳞状细胞癌（HNSCC）仍然是一种毁灭性的疾病，与肿瘤和积极治疗相关的发病率很高。目前的分期方法不足以预测哪些患者处于危险之中，需要积极的治疗；因此，低风险患者经常遭受不必要治疗的发病率。HNSCC预后的最佳预测指标仍然是是否存在颈部转移。通过使用分子分析来增强临床分期系统的预测能力的尝试已被证明是无效的，因为当检查单个基因缺陷或表达时，预测准确性低，结果相互矛盾。新兴技术使得检测肿瘤样本中大量基因的表达成为可能。这些数据在预测乳腺癌、肺癌和其他上皮性和非上皮性肿瘤的侵袭性和/或转移性方面非常有用。利用基因阵列技术，我们建议确定HNSCC中预测转移存在与否的基因表达谱。这项技术的成功将允许对转移风险高的肿瘤进行积极治疗，而低风险的患者则可以避免与积极治疗相关的发病率。由于颈部转移的HNSCC与生存率相关，这些标志物也可以预测生存率。

DESCRIPTION (provided by applicant): Head and neck squamous cell carcinoma (HNSCC) remains a devastating disease with significant morbidity related to the tumor and to aggressive treatment. Current staging methods are inadequate to predict which patients are at risk and are in need of aggressive therapy; therefore patients at low risk are frequently subjected to morbidity of unnecessary therapy. The best predictor of outcome in HNSCC remains the presence or absence of neck metastases. Attempts to augment the predictive power of the clinical staging system through use of molecular analyses have proven unfruitful because of low predictive accuracy and conflicting results when individual gene defects or expressions were examined. Emerging technologies have made possible the examination of the expression of large numbers of genes within tumor samples. This data has been very useful in predicting aggressiveness and/or metastases of breast cancers, lung cancers and other epithelial and nonepithelial tumors. Using gene array technology, we propose to determine gene expression profiles in HNSCC that predict the presence or absence of metastases. Success of this technique will allow aggressive treatment of tumors at high risk of metastases, while patients at low risk are spared morbidity associated with aggressive therapies. Since neck metastases of HNSCC correlates with survival, these markers may also predict survival.