[Multivariate survival analysis in patient with laryngeal squamous cell carcinomas].

Objective: This study was designed to analyze the most important factors affecting the prognosis of the patients with laryngeal squamous cell carcinoma (LSCC).

Method: The expression of S-phase kinase associated protein 2(Skp2), p27, E-cadherin (E-cad) and alpha-catenin (alpha-cat) in 79 cases of LSCC and 10 cases of adjacent normal laryngeal mucosa tissues were evaluated by SP immunohistochemistry methods, 12 clinicopathological factors affecting the prognosis of LSCC were analyzed using univariate model and multivariate regression model.

Result: (1) The overexpression rate of Skp2 was significantly higher in LSCC (53.16%) than in adjacent normal laryngeal mucosa tissue (0%) (P < 0.05). The overexpression rate of p27 was significantly lower in LSCC (30.38%) than in adjacent normal laryngeal mucosa tissue (90%) (P < 0.05). The positive expression rate of E-cad was significantly lower in LSCC (34.18%) than in adjacent normal laryngeal mucosa tissue (100%) (P < 0.05). The positive expression rate of alpha-cat was significantly lower in LSCC (40.51%) than in adjacent normal laryngeal mucosa tissue (100%) (P < 0.05). (2) There was a significantly higher 5-year survival rate in reduced Skp2 expression group (72.18%) when compared with that of Skp2 overexpression group (44.17%) in LSCC (P < 0.01). There was a significantly higher 5-year survival rate in p27 overexpression group (72.98%) when compared with that of reduced p27 expression group in LSCC (51.13%) (P < 0.01). The 5-year survival rates of positive E-cad expression group and positive alpha-cat expression group in LSCC were 63.80% and 81.74% respectively, the 5-year survival rates of negative E-cad expression group and negative alpha-cat expression group were 50.68% and 41.09% respectively. There were significantly higher 5-year survival rates in positive expression groups when compared with that of negative expression groups (P < 0.05 and P < 0.01). (3) The univariate analysis showed: histology grade, status of cervical lymph node, clinical stage, T stage, recurrence, Skp2 expression, p27 expression, E-cad expression and alpha-cat expression were proven to significant (P < 0.05); Multivariate analysis showed: Skp2 expression, alpha-cat expression and recurrence were independent prognostic factors of survival of LSCC patients (P < 0.05). (4) Skp 2 expression was inversely associated with p27 expression, p27 expression was significantly associated with alpha-cat expression, E-cad expression was significantly associated with alpha-cat expression.

Conclusion: The chief prognostic factors of survival of LSCC patients were Skp2 expression, alpha-cat expression and recurrence.