title: Stage and mRNA expression of survivin in lymph node as prognostic indicators in patients with oral squamous cell carcinoma.
abstract: Squamous cell carcinoma (SCC) is the most common malignant head and neck tumor and is responsible for more than 90% of head and neck cancers and accounts for 4.5% of all malignant tumors in males and 3.5% in females in South Korea. The purpose of this study was to investigate the correlation of suggested clinico-pathological prognostic factors such as gender, age, T score (T number in TNM), clinical stage, proliferation, invasion index, and lymph node metastasis to the survival of SCC patients in Korea. Furthermore, cytokeratin (CK), carcinoembryonic antigen (CEA), and recently documented apoptosis related protein, survivin, were analyzed by RT-PCR. In 113 patients, survival curves were estimated by the Kaplan-Meier method and nominal or numeric variable influence on survival was studied by Univariate and Multivariate Regression analysis (Cox proportional hazards model). Univariate analysis demonstrated that gender and age factor had no significant effect on survival rate. T score, on the other hand, significantly influenced survival and univariate analysis demonstrated that Stage 4 group had a significantly lower survival rate than the other stage groups but differentiation and invasion index factors had no significant effect on survival rate. Using a 50% cut-off point, patients with lower PCNA scores showed no survival advantages over those with higher PCNA scores but lymph node metastasis was a significant survival predictor in univariate analysis. In addition, lymph node CK and survivin mRNA expression have significant effects on OSCC patient survival rate. This means that prognostic value can be amplified by coincident analysis of T score, pathologically confirmed lymph node metastasis, and lymph node CK or survivin mRNA expression. Multivariate analysis using Cox's proportional hazards model, clinical TNM stage and lymph node survivin mRNA expression were independent OSCC prognostic factors, which support cancer staging based on the TNM as a powerful prognostic variable and lymph node survivin expression might provide predictive information for OSCC patient survival.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Dental Research Institute, College of Dentistry, Seoul National University, Yeon-gun dong 28, Chouro-Ku, Seoul 110-749, South Korea.
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Koo-Young
authors.initials: KY
authors.lastname: Lim
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Il-Woo
authors.initials: IW
authors.lastname: Nam
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Hoon
authors.initials: H
authors.lastname: Myoung
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000235:genetics* / Q000473:pathology*; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D007633:Keratins / Q000032:analysis; D008207:Lymphatic Metastasis; D008297:Male; D008869:Microtubule-Associated Proteins / Q000096:biosynthesis*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000235:genetics* / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins; D009367:Neoplasm Staging; D011379:Prognosis; D012333:RNA, Messenger / Q000096:biosynthesis*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012737:Sex Factors; D016019:Survival Analysis; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D002272:Carcinoembryonic Antigen; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D012333:RNA, Messenger; D000077022:Survivin; D007633:Keratins