2012年8月23日 訊 /生物谷BIOON/ --一一項(xiàng)最新研究發(fā)現(xiàn)一組分子標(biāo)記可以幫助醫(yī)生確定哪些低等級(jí)的口腔黏膜癌前病變患者會(huì)發(fā)展演變成口腔癌，相關(guān)研究論文發(fā)表在Cancer Prevention Research雜志上。
Miriam Rosin博士說：該研究結(jié)果有助于幫助我們認(rèn)識(shí)到不是每個(gè)低等級(jí)口腔癌前病變的人都會(huì)發(fā)展罹患癌癥,。不過，該研究結(jié)果能便于臨床醫(yī)生更好地了解哪些患者需要更加密切的跟進(jìn)關(guān)注,。
口腔癌是一個(gè)全球性的公共衛(wèi)生問題，每年在世界各地有近30萬新發(fā)病例,。之前,，許多這些癌癥癌癥都出現(xiàn)了癌前病變現(xiàn)象。嚴(yán)重的癌前病變與癌癥罹患風(fēng)險(xiǎn)應(yīng)早已被證實(shí)確定的,。然而,，其中一個(gè)巨大的挑戰(zhàn)就是如何區(qū)分低度病變是不是最有可能發(fā)展為癌癥。
在2000年,，Rosin和他的同事們收集了那些口腔黏膜癌前病變發(fā)展到癌癥的患者樣本,，根據(jù)他們的DNA差異，將患者分為低風(fēng)險(xiǎn)或高風(fēng)險(xiǎn)類別,，研究人員能夠正確地區(qū)分出哪些人更容易發(fā)展為癌患者,。
他們分析了296例有輕度或中度口腔異常增生的患者，隨后經(jīng)過多年的BC口腔活檢測(cè)試,，結(jié)果發(fā)現(xiàn)那些歸類為高風(fēng)險(xiǎn)的患者發(fā)展罹患口腔癌的風(fēng)險(xiǎn)有增加近23倍,。
接著被稱為雜合性丟失的兩個(gè)額外的DNA分子風(fēng)險(xiǎn)標(biāo)記物被用來更好地區(qū)別病人罹患癌癥的風(fēng)險(xiǎn)。他們使用前瞻性研究中的疾病樣本,，并將患者分為分為低,、中、高風(fēng)險(xiǎn)組,。
Rosin說：相比較于低風(fēng)險(xiǎn)的患者來說,、中等風(fēng)險(xiǎn)的患者罹患口腔癌的風(fēng)險(xiǎn)增加了11倍，高風(fēng)險(xiǎn)組的患者罹患口腔癌的風(fēng)險(xiǎn)增加了52倍,。
在歸類為低風(fēng)險(xiǎn)的患者中,，只有3.1％的人在五年內(nèi)可能會(huì)發(fā)展得癌癥疾病。相比之下,，中等風(fēng)險(xiǎn)的患者5年內(nèi)有16.3％的可能性會(huì)得癌癥，而高風(fēng)險(xiǎn)的患者5年有63.1％的可能性的癌癥,。
Rosin表示：識(shí)別早期病變可能便于臨床醫(yī)生更早有機(jī)會(huì)介入治療,，可能有助于在低風(fēng)險(xiǎn)的情況下就防止癌癥的發(fā)生。（生物谷：Bioon.com）
編譯自：Researchers identified markers that predict progression of oral lesions to cancer
doi:10.1158/1940-6207.CAPR-12-0173
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Loss of Heterozygosity (LOH) Profiles—Validated Risk Predictors for Progression to Oral Cancer
Lewei Zhang4,5, Catherine F. Poh1,2,4,5, Michele Williams2,4, Denise M. Laronde1,4, Ken Berean5, Pamela J. Gardner3, Huijun Jiang1, Lang Wu6, J. Jack Lee8, and Miriam P. Rosin1,7
A major barrier to oral cancer prevention has been the lack of validated risk predictors for oral premalignant lesions (OPL). In 2000, we proposed a loss of heterozygosity (LOH) risk model in a retrospective study. This paper validated the previously reported LOH profiles as risk predictors and developed refined models via the largest longitudinal study to date of low-grade OPLs from a population-based patient group. Analysis involved a prospective cohort of 296 patients with primary mild/moderate oral dysplasia enrolled in the Oral Cancer Prediction Longitudinal Study. LOH status was determined in these OPLs. Patients were classified into high-risk or low-risk profiles to validate the 2000 model. Risk models were refined using recursive partitioning and Cox regression analyses. The prospective cohort validated that the high-risk lesions (3p and/or 9p LOH) had a 22.6-fold increase in risk (P = 0.002) compared with low-risk lesions (3p and 9p retention). Addition of another 2 markers (loci on 4q/17p) further improved the risk prediction, with five-year progression rates of 3.1%, 16.3%, and 63.1% for the low-, intermediate-, and high-risk lesions, respectively. Compared with the low-risk group, intermediate- and high-risk groups had 11.6-fold and 52.1-fold increase in risk (P < 0.001). LOH profiles as risk predictors in the refined model were validated in the retrospective cohort. Multicovariate analysis with clinical features showed LOH models to be the most significant predictors of progression. LOH profiles can reliably differentiate progression risk for OPLs. Potential uses include increasing surveillance for patients with elevated risk, improving target intervention for high-risk patients while sparing a large number of low-risk patients from needless screening and treatment.
