부산대학교 도서관

BACKGROUND: Hypopharyngeal squamous cell carcinoma (HPC) has the worst prognosis in head and neck squamous cell carcinoma (HNSCC), which may be ascribed to the high incidence of regional and distant metastases. Cortactin is encoded by the CTTN (or called EMS1) gene located on chromosome 11q13. Cortactin has consistently been associated with aggressiveness, lymph node metastasis, and poor outcome in HNSCC. To analyze the influence of cortactin expression on regional and distant metastases and survival is helpful to understand effect of a certain gene on treatment outcomes and to determine an optimal treatment strategy. METHODS: Tissue specimens from a cohort of 140 consecutive patients with HPC receiving pharyngolaryngectomy with/without neck dissection between December 2009 and May 2015 were retrospectively collected. Gene amplification was performed by real-time PCR. Cortactin expression status was evaluated by immunohistochemistry. Associated data were recorded and analyzed. RESULTS: A total of 140 patients were included with a mean age of 55 ± 10 years and with a follow-up of surviving patients ranging from 67 to 132 months. Multivariate analysis showed that lymphovascular invasion (OR = 5.89; 95% CI 1.79-19.40; p = 0.004) and cortactin overexpression (OR = 3.89; 95% CI 1.51-10.03; p = 0.005) were significant independent predictors of cervical nodal metastases. Distant metastasis was related to cervical nodal metastasis ( p = 0.009), cortactin overexpression ( p = 0.018), extracapsular spread ( p ＜ 0.001), perineural ( p = 0.035) and lymphovascular invasion ( p = 0.001). Kaplan-Meier analysis showed a significant correlation between cortactin overexpression and reduced disease-specific survival ( p = 0.037). CONCLUSIONS: In this study, we considered that cortactin overexpression is an independent predictor of cervical nodal metastasis and distant metastasis, and presumably influences survival of the disease. In HPC patients with cortactin overexpression, elective neck dissection and/or adjuvant radiotherapy/chemoradiotherapy were recommended to achieve a better regional and distant control, and close follow up for distant metastasis is mandatory.