期刊
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY
卷 134, 期 4, 页码 363-369出版社
AMER MEDICAL ASSOC
DOI: 10.1001/archotol.134.4.363
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资金
- NCI NIH HHS [P30 CA46592, P50 CA097248, R01 CA083087, P30 CA046592, R01 CA083087-05, P50 CA97248, R01 CA83087, P30 CA046592-20, P50 CA097248-06A1] Funding Source: Medline
Objective: To assess tumor markers in advanced laryngeal cancer. Design: Marker expression and clinical outcome. Patients: Pretreatment tumor biopsy specimens were analyzed from patients enrolled in the Department of Veterans Affairs Laryngeal Cancer Study. Main Outcome Measures: Expression of p53 (OMIM TP53) and Bcl-xL (OMIM 600039) in pretreatment biopsy specimens was assessed for correlation with chemotherapy response, laryngeal preservation, and survival. Results: Higher rates of larynx preservation were observed in patients whose tumors expressed p53 vs those that did not (80% [36 of 45 patients] vs 59% [24 of 41 patients], P=.03). Higher rates of larynx preservation were also observed in patients whose tumors expressed low levels of Bcl-xL vs high levels of Bcl-xL (90% [18 of 20 patients] vs 60% [30 of 50 patients], P=.02). Patients were categorized into 3 risk groups (low, intermediate, and high) based on their tumor p53 and Bcl-xL expression status. Patients whose tumors had the high-risk biomarker profile (low p53 expression and high Bcl-xL expression) were less likely to preserve their larynx than patients whose tumors had the intermediate-risk biomarker profile (high p53 expression and low or high Bcl-xL expression) or the low-risk biomarker profile (low p53 expression and low Bcl-xL expression). The larynx preservation rates were 100% (10 of 10 patients), 77% (26 of 34 patients), and 54% (7 of 13 patients) for the low-risk, intermediate-risk, and high-risk groups, respectively (P=.04, Fisher exact test). Conclusion: Tumor expression of p53 and Bcl-xL is a strong predictor of successful larynx preservation in patients treated with induction chemotherapy and followed by radiation therapy in responding tumors.
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