血清中腫瘤標記HER-2/neu及SCCA值與口腔鱗狀細胞癌關聯性的研究

A study of correlation between tumor marker (HER-2/neu & SCCA) and oral squamous cell carcinoma

蔡宗霖(Tsung-Lin Tsai)

指導教授 ： 陳中和

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2004年)

摘要

HER-2/neu (human epidermal growth factor receptor-2)在許多文獻中提到HER-2/neu與口腔鱗狀細胞癌有關，而致癌基因HER-2/neu 的過度表現常與預後不佳及容易轉移有關。Squamous Cell Carcinoma associated Antigen (SCCA)是腫瘤週遭的T-lymphocytes所產生的抗原，臨床上許多癌症也以SCCA值當作腫瘤標記。本研究的目的在於探討口腔鱗狀細胞癌病患其血清中腫瘤標記HER-2/neu及SCCA在治療前後的變化。實驗對象: 高雄醫學大學附設醫院口腔顎面外科2002年9月到2004年1月，經臨床及口腔病理切片診斷為口腔鱗狀細胞癌病患46位為實驗組。在未經治療與治療後1個月，各萃取出血清，以連結免疫吸附分析法(ELISA)的方法，測量口腔鱗狀細胞癌病患在治療前後血清中 HER-2/neu 及以放射免疫分析(RIA)的方法，測量口腔鱗狀細胞癌病患在治療前後血清中SCCA 值。經one-way ANOVA (變異數分析) 、Pair t test （配對t檢定）、Kaplan-Meier method、 Proportional hazardz models （Cox regression）統計方法加以分析。初步結果發現腫瘤標記HER-2/neu 及 SCCA在治療前後有統計上顯著差異(P<0.05)；治療前腫瘤標記HER-2/neu與臨床上局部淋巴結轉移有統計上顯著差異(P = 0.0017)；治療前腫瘤標記SCCA與臨床上腫瘤大小有統計上顯著差異(P = 0.0254)；65%口腔鱗狀細胞癌病患有過度表現；治療後HER-2/neu 及 SCCA一起偵測可提高預測疾病復發率能力；治療前與治療後HER-2/neu 及 SCCA一起偵測可提高預測疾病存活率能力。由這些結果建議監測病患血清中腫瘤標記HER-2/neu 及 SCCA，將可評估口腔鱗狀細胞癌的復發，當作追蹤偵查口腔癌的標記。

關鍵字

口腔癌

並列摘要

abstract
Overexpression of c-erbB-2（also known as HER-2/neu）has been found in many human cancers,including head and neck squamous cell carcinoma. HER-2/neu overexpression has been associated with advanced disease, metastasis, and poor clinical outcome in breast cancer. Squamous cell carcinoma associasted antigen is widely used as a tumor marker in a broad variety of carcinomas of squamous cell origin in different body sites. Purpose of this study was to investigate the pre-treatment and post-treatment values of HER-2/neu and SCCA in patients treated for oral squamous cell carcinoma. Materials and methods: 46 patients with primary OSCC were obtained from the Department of Oral and Maxillofacial Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University between 2003 and 2004. Serum samples were obtained before treatment and at intervals following treatment. HER-2/neu levels were determined by Enzyme-linked Immunosorbant Assay（ELISA） and SCCA levels were determined by Radioimmunoassay（RIA）. Significant correlation was found between HER-2/neu and lymph node metastasis（p=0.0017）. SCCA was also correlated with tumor size（p=0.0254）.Both HER-2/neu and SCCA could obtain a significant mean reduction after treatment. We chose the 95% level of normal controls as a cut-off to distinguish individuals with elevated levels. The number of OSCC (65%) with an elevated serum HER-2/neu protein level was significantly greater than that of the control group. The combination of HER-2/neu and SCCA significantly improved yhe predicting power. Conclusion: HER-2/neu and SCCA may be a useful marker in evaluating therapeutic effects and in monitoring the recurrence status of oral squamous cell carcinoma.

並列關鍵字

SCCA、 HER-2/neu、OSCC

參考文獻

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