口腔癌是口腔黏膜經致癌因子的刺激產生，根據衛生福利部公布2013年全國十大癌症死亡資料中顯示，口腔癌的死亡率排名為第6名，男性主要癌症死因之第4位。口腔癌的發生是一個多重步驟的過程，涉及致癌基因的活化(oncogene activation)和腫瘤抑制基因的失能(tumor supressor gene inactivation)等許多因素，如吸煙，酒精，病原感染和遺傳因素。
目前口腔癌臨床治療上也遭遇到許多困難與瓶頸，主要原因來自於口腔癌的局部侵犯跟高度淋巴轉移的比率。雖然可利用放射線治療或化學藥物治療消滅剩餘的癌細胞，但是仍有少部分癌細胞對於放射線治療或化學藥物治療具有抵抗力而無法被消滅。除了尋找更好的標的蛋白並研發標的治療外，如何將藥物專一地送到腫瘤組織，以及克服口腔癌治療的瓶頸等，都是癌症研究人員必須克服的問題。
本研究於彰化基督教醫院收集了287個口腔鱗狀上皮細胞癌的病理組織，藉由免疫染色判讀口腔癌病理組織PBK/TOPK (PDZ-binding kinase/T-LAK cell-originated protein kinase)表現的情況，並且利用統計分析驗證PBK/TOPK的表現與口腔癌預後的關聯。
結果我們發現口腔鱗狀細胞癌中PBK / TOPK主要於細胞核或細胞質中表現，而且在正常口腔黏膜中難以檢測到。進一步的分析發現PBK / TOPK的表現與年輕族群、吸煙、中度和低度細胞分化、晚期病理分期和較嚴重的頸部淋巴轉移的患者病情的預後顯著相關。證實了PBK / TOPK在某些族群中可以當作口腔癌患者的預後標誌物。
Background: Oral cancer is a common cancer with poor prognosis. In Taiwan the mortality of oral cancer ranks fourth among males and sixth in the entire population. Oral carcinogenesis is a multistep process that involves oncogenes and tumor suppressor genes via many factors, such as smoking, alcohol, pathogenic infection, and genetics factors. Like other malignancies, a variety of staging systems were used for predicting the prognosis of patients and to select appropriate treatment modalities.
Materials and Methods: We evaluated the expression of PBK/TOPK (PDZ-binding kinase/T-LAK cell-originated protein kinase) and its prognostic significance in oral cancer. PBK/TOPK expression was measured by immunohistochemical staining of samples from 287 patients with oral cancer from the Department of Pathology of Chunghwa Christian Hospital. The association between PBK/TOPK expression and clinicopathological features was analyzed. The prognostic value of PBK/TOPK for overall survival was determined by Kaplan-Meier analysis and Cox proportional hazard models.
Results：A high PBK/TOPK expression level was correlated with long overall survival. The prognostic role of PBK/TOPK expression was significant in young patients (p < 0.05), patients with smoking habits (p < 0.05), and late stage disease (p < 0.05).
Conclusion: Our results suggest that PBK/TOPK is specifically expressed in oral cancer and that increased expression is associated with good prognosis in some particular patients. High PBK/TOPK expression, either alone or in subgroups according to clinicopathological features, may serve as a favorable prognostic marker for patients with oral cancer.
