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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 2  |  Page : 258-264

Prognostics of Cyclin-D1 expression with chemoradiation response in patients of locally advanced oral squamous cell carcinoma


1 Department of Radiotherapy, C.S.M. Medical University, Lucknow, Uttar Pradesh, India
2 Department of Pathology, C.S.M. Medical University, Lucknow, Uttar Pradesh, India
3 Department of Surgical Oncology, C.S.M. Medical University, Lucknow, Uttar Pradesh, India
4 Biometry and Statistics Division, Institute for Data Computing and Training, Lucknow, Uttar Pradesh, India

Correspondence Address:
Seema Gupta
Department of Radiotherapy, C.S.M. Medical University, Chowk City, Lucknow - 226 003, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.136549

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Objective: Cyclin-D1 has been strongly implicated in cell cycle proliferation particularly in the G1/S checkpoint in the cell cycle, and prognosis in many human malignancies. The present study evaluates its prognostic significance with chemoradiation response in patients of locally advanced oral squamous cell carcinoma (OSCC). Materials and Methods: A total of 97 OSCC patients (females = 19 and males = 78), aged 20-67 years and stage III/IV were recruited. Treatment response was assessed according to World Health Organization criteria. Cyclin-D1 expression in tumor tissue was estimated by immunohistochemical method and quantified as percentage positive nuclei. Results: The Cyclin-D1 expression showed significant (P < 0.01 or P < 0.001) association with tumor size, lymph node status, and clinical stage. After chemoradiation, there were 53.6% complete response (CR) and 34.0% partial response (PR) in primary tumor, and 49.5% CR and 39.2% PR in lymph node; giving an overall response rate of 85.6%. Further, the mean Cyclin-D1 expression showed significant (P < 0.05 or P < 0.001) and inverse association with chemoradiation responses (tumor size, lymph node status and overall treatment response). The 2-year progression-free and overall survival (OS) was 95.89% and 83.31% respectively. Multivariate Cox regression analysis found site of primary tumor, clinical stage, and Cyclin-D1 expression the significant (P < 0.05 or P < 0.01) and independent prognostic markers of OS and among these Cyclin-D1 expression showed the worst prognosis. The high Cyclin-D1 expression (>50%) also showed significantly lower survival in OSCC patients when compared with those had low (<10%) and moderate expressions (10-50%) (Logrank test: χ2 = 44.42, P < 0.001). Conclusion: The high Cyclin-D1 expression may serve as a poor prognostic marker in OSCC.

Abstract in Chinese

细胞周期蛋白 D1的表达与局部晚期口腔鳞状细胞癌患者放化疗反应的预测 摘要 目的:细胞周期蛋白D1主要在细胞周期的G1 / S检查点发挥作用,与细胞增殖高度相关,特别是,并与多种恶性肿瘤的预后相关。本研究评估其在局部晚期口腔鳞状细胞癌患者放化疗反应(OSCC)的预后意义。 材料和方法:共97例口腔癌患者(女性19,男性为78),20岁到67岁, III / IV期患者。治疗反应是根据世界卫生组织的标准进行评估。在肿瘤组织中Cyclin D1的表达采用免疫组化方法估计并按阳性核百分比定量。 结果:细胞周期蛋白D1的表达与肿瘤大小,淋巴结状态,临床分期显著相关(P<0.01或P<0.001)。放化疗后,有53.6%的病人完全缓解(CR),34%部分缓解(PR),在淋巴结有49.5% CR和39.2% PR;整体反应率为85.6%。此外,平均细胞周期蛋白 D1的表达与放化疗反应(肿瘤大小,淋巴结状态和整体治疗的反应)呈显著负相关(P<0.05或P<0.001)。2年的无进展生存和总体生存率(OS)分别为95.89%和83.31%。多因素Cox回归分析发现原发肿瘤的位置、临床分期,和细胞周期蛋白D1的表达显著相关(P<0.05或P<0.01),是独立的预后标志,在细胞周期蛋白中,D1高表达的病例预后最差。在口腔鳞状细胞癌患者中,细胞周期蛋白D1的高表达组(>50%)与低表达组(<10%)和中表达组(10%~50%)相比生存率较低(对数秩检验:χ2=44.42,P<0.001)。 结论:细胞周期蛋白D1的高表达可作为口腔鳞状细胞癌预后差的标志物。 关键词:放化疗,细胞周期蛋白D1,免疫组织化学,鳞状细胞癌



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