Zusammenfassung
Hintergrund: Intensive Forschungsarbeiten der letzten Jahrzehnte befassten sich mit der Suche nach Faktoren, die bei Plattenepithelkarzinomen des Kopf-Halsbereiches prognostischen Wert besitzen. Im Gegensatz zu anderen Tumor-Systemen, wie beispielsweise dem Kolonkarzinom, bei dem die Progression des Tumors mit der Expression bzw. Inaktivierung definierter Gene in meist gleicher Reihenfolge vonstatten geht (zur Übersicht siehe [1]), erweisen sich die Zellen von Plattenepithelkarzinomen meist als sehr heterogen. Methode: Im Rahmen dieser Arbeit wurden Publikationen über die wichtigsten immunhistochemischen, molekularbiologischen und zytogenetischen Prognosemarker bei Kopf-Hals-Karzinomen analysiert, und die Ergebnisse zusammengefasst. Ergebnisse: Die hier diskutierten Prognosefaktoren wurden in folgende Schwerpunktbereiche eingeteilt: Apoptose, Zellzyklusregulation, Virusinfektionen, Zytokine und Wachstumsfaktoren/Wachstumsfaktorrezeptoren, Angiogenese und Hypoxie, Proteasen, Zell-Zell-Kontakte und Zell-Matrixkontakte, Zytokeratinfragmente, Chromosomenaberrationen und genetisch bedingte chemische Suszeptibilität. Schlussfolgerungen: Signifikante Prognosemarker sind wichtig für die klinische Verlaufskontrolle von Krebserkrankungen und für die Auswahl von Therapiekonzepten. Dennoch lässt sich keiner der ausgewerteten Faktoren zum jetztigen Zeitpunkt als universeller und alleiniger Prognosemarker für Plattenepithelkarzinome des Kopf-Halsbereichs einsetzen.
Prognostic Significance of Biological Parameters in Head and Neck Tumors - Review of the Literature
Background: Scientific research work of the last decade has been performed in order to investigate biological parameters of prognostic significance for head and neck squamous cell carcinoma. In contrast to other cancer types, like colon carcinoma, where tumour progression is accompanied by an almost defined sequel of gene activations and inactivations, cells of squamous cell carcinoma behave more heterogenously. Methods: Publications concerning the most important immunohistochemical, molecular biological and cytogenetic prognostic markers in head and neck cancer have been analyzed. Results: The prognostic markers discussed in this publication have been classified into the following areas: Apoptosis, cell cycle regulation, viral infections, cytokines and growth factors/growth factor receptors, angiogenesis and hypoxia, proteinases, cell-cell contacts and cell-matrix contacts, cytokeratin fragments, chromosomal rearrangements and genetically inherited susceptibility to toxic reagents. Conclusions: Significant prognostic markers are important for the clinical follow-up of patients and the choice of therapeutical approach. However, none of the factors analyzed can be used as an individual and universal prognostic marker at present.
Schlüsselwörter:
Kopf-Hals-Plattenepithelkarzinom - Metastasen - Prognosemarker - Übersicht
Key words:
Head and neck cancer - Metastasis - Prognostic marker - Review
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Marianne Schmidt
Universität Würzburg Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke
Josef-Schneider-Straße 11 97080 Würzburg
Email: E-mail: marianne.schmidt@mail.uni-wuerzburg.de
