RESUMEN
BACKGROUND: Despite improvement in therapeutic techniques, patients with early-stage laryngeal cancer still recur after treatment. Gene expression prognostic models could suggest which of these patients would be more appropriate for testing adjuvant strategies. MATERIALS AND METHODS: Expression profiling using whole-genome DASL arrays was carried out on 56 formalin-fixed paraffin-embedded tumor samples of patients with early-stage laryngeal cancer. We split the samples into a training and a validation set. Using the supervised principal components survival analysis in the first cohort, we identified gene expression profiles that predict the risk of recurrence. These profiles were then validated in an independent cohort. RESULTS: Gene models comprising different number of genes identified a subgroup of patients who were at high risk of recurrence. Of these, the best prognostic model distinguished between a high- and a low-risk group (log-rank P<0.005). The prognostic value of this model was reproduced in the validation cohort (median disease-free survival: 38 versus 161 months, log-rank P=0.018), hazard ratio=5.19 (95% confidence interval 1.14-23.57, P<0.05). CONCLUSIONS: We have identified gene expression prognostic models that can refine the estimation of a patient's risk of recurrence. These findings, if further validated, should aid in patient stratification for testing adjuvant treatment strategies.
Asunto(s)
Carcinoma de Células Escamosas/genética , Neoplasias Laríngeas/genética , Modelos Genéticos , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Estudios de Cohortes , Femenino , Formaldehído , Predisposición Genética a la Enfermedad , Humanos , Neoplasias Laríngeas/patología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/genética , Estadificación de Neoplasias , Adhesión en Parafina , Pronóstico , Modelos de Riesgos Proporcionales , Reproducibilidad de los Resultados , Fijación del TejidoRESUMEN
Controversy still exists regarding the precise contribution of the nasal septum to facial growth and development. Several reports indicate that early surgical intervention for the correction of nasal septum abnormalities leads to a high recurrence rate that necessitates revision procedures in adulthood. In this study we compared a group of patients with posterior nasal septum deformities to a control group by using cephalometric radiographs and recording several measurements on composite tracings. Our data, analysed by a computerized statistical programme, demonstrate significant differences between the two groups, supporting the view that the development of the anterior part of the neurocranium influences the development of posterior nasal septum deformities.