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背景与目的:已经发现富含半胱氨酸的酸性分泌蛋白(secreted protein acidic and richin cysteine,SPARC)在多种恶性肿瘤中有不同程度的表达,并且与肿瘤生物学行为、预后相关。本研究通过检测SPARC在临床Ⅱ期舌体鳞癌的表达,分析其表达强度与舌癌预后的关系。方法:收集55例中山大学肿瘤防治中心头颈外科1999年1月至2003年12月临床Ⅱ期(T2N0M0)舌体鳞癌术后标本,25例舌炎症旁组织作对照,免疫组化定性检测SPARC的表达。分析其表达强度与舌癌患者生存、复发、隐匿性淋巴结转移的关系。结果:55例舌癌术后标本中SPARC阳性率为49.1%,25例对照舌上皮组织不表达(P<0.001);SPARC阳性患者的5年累积生存率为30.0%,SPARC阴性患者5年累积生存率为85.3%,统计学分析差异有统计学意义(P=0.005);SPARC在隐匿性淋巴结转移阳性与阴性患者表达率分别为86.7%及35.0%,差异有统计学意义(P=0.001)。SPARC在复发与否患者表达率分别100%及31.7%,差异有统计学意义(P<0.001)。SPARC的表达与隐匿性淋巴结转移、复发呈正相关,相关系数依次为0.460(P<0.001)、0.595(P<0.001)。结论:SPARC在临床Ⅱ期舌体鳞癌中表达高于正常舌上皮组织,其表达与生存率、隐匿性淋巴结转移、复发呈正相关。
BACKGROUND AND PURPOSE: It has been found that the secreted protein acidic and rich cysteine (SPARC) is expressed in many malignant tumors to some extent and is related to the biological behavior and prognosis of the tumor. This study was to detect the expression of SPARC in clinical stage Ⅱ tongue squamous cell carcinoma and to analyze its relationship with the prognosis of tongue cancer. Methods: Fifty-five cases of squamous cell carcinoma of the tongue (T2N0M0) from January 1999 to December 2003 in Head and Neck Surgery Center of Cancer Center of Sun Yat-sen University were collected. Twenty-five cases of tongue paratumor tissues were collected as controls. Immunohistochemical SPARC expression. The relationship between expression intensity and survival, recurrence and occult lymph node metastasis in tongue cancer patients was analyzed. Results: The positive rate of SPARC in 55 cases of tongue cancer specimens was 49.1% and 25 cases of tongue tongue epithelial tissues were not expressed (P <0.001). The 5-year cumulative survival rate was 30.0% in SPARC-positive patients and 5 years in SPARC-negative patients The survival rate was 85.3%, the difference was statistically significant (P = 0.005). The positive expression rate of SPARC in patients with occult lymph node metastasis was 86.7% and 35.0%, respectively, with significant difference (P = 0.001) . SPARC in patients with recurrent or not, respectively, the rate of 100% and 31.7%, the difference was statistically significant (P <0.001). The expression of SPARC was positively correlated with occult lymph node metastasis and relapse, the correlation coefficients were 0.460 (P <0.001) and 0.595 (P <0.001) respectively. CONCLUSIONS: The expression of SPARC in clinical stage Ⅱ tongue squamous cell carcinoma is higher than that in normal tongue epithelial tissues. The expression of SPARC is positively correlated with the survival rate, occult lymph node metastasis and recurrence.