循环肿瘤细胞（CTC）是检测肿瘤转移/复发的先进技术，但单纯CTC检测尚存在缺陷；EGFR及其变异体EGFRvШ与头颈鳞癌转移、靶向治疗耐药性密切相关；SDF-1/CXCR4轴在头颈鳞癌侵袭及转移中起重要作用；但检测CTC及CXCR4/EGFRvШ在头颈鳞癌转移/复发的作用缺乏系统性研究。.拟研究：头颈鳞癌原发灶、淋巴结转移灶、远处转移灶对应检测CXCR4和EGFRvШ及其共表达；初步构建CXCR4+/EGFRvШ+头颈鳞癌细胞，探讨CXCR4或/和EGFRvШ在头颈鳞癌细胞侵袭、转移中的作用机制，建立头颈鳞癌CTC及其分子表达检测的研究技术，为头颈鳞癌转移/复发的早期预测奠定临床及实验基础。

Circulating tumor cells (CTC) detection is advanced technology on prediction of the metastasis and recurrence of head and neck SCC but still need to be improved. EGFR and its variant EGFRvШ were proved related closely to EGFR target therapy of treatment resistance on head and neck SCC patients and tumor invasion and metastasis. SDF-1/CXCR4 axis plays an important role in invasion and lymph node metastasis in head and neck SCC. Unfortunately, until now, there still short of systematic and large sample research on CTC/CXCR4/EGFRvIII of SCC on head and neck..In this study, we plan to collect serial tumor tissues including: primary tumor tissue, metastatic lymph node lesions and distant metastatic lesion specimens to detect CXCR4 and EGFR/EGFRvШ and their co-expression on the corresponding tissues. Detection of CTC in peripheral blood and observe its expression of CXCR4/EGFRvIII using CellSearch system. Try to reveal primary tumor cell-CTC-distant metastatic tissue CXCR4/EGFRvШ expression and its clinical relationship between relapse and metastasis of head and neck SCC. Construct CXCR4+/EGFRvШ+ in SCC cell lines to investigate different of migration and invasion ability in different type expression cell lines in vitro and in vivo. Base on both clinical study and experimental research, we try to predict earlier head and neck SCC recurrence and metastasis.

目的：检测EGFRvⅢ和CXCR4在HNSCC组织中的表达情况，初步探讨其在侵袭、转移中可能的作用。材料与方法：选取2013.05-2016.11在我院收治并接受治疗的HNSCC患者60例，男56例，女4例；年龄在40-82岁之间；其中喉鳞癌44例，下咽鳞癌14例，鼻腔鼻窦鳞癌2例；根据AJCC 2010 pTNM分期，III期17例，IVa期40例，IVb期 3例;肿瘤分化程度：高分化13例，中分化31例，低分化16例；取肿瘤原发灶和/或淋巴结转移灶组织作为实验组；取10例癌旁正常粘膜组织作为对照（对照组）。利用免疫组化法分别观察肿瘤的原发灶、转移灶及对照组中EGFRvⅢ和CXCR4的表达情况。利用Image-Pro Plus 对免疫组化结果行定量分析；利用SPSS 23.0和Graphpad-Prism 5.0对定量结果进行统计分析。结果：EGFRvⅢ和CXCR4在HNSCC均高表达，其表达与患者的年龄、性别、部位、分化程度、T分级、肿瘤分期均无明显相关性（P﹥0.05），但与N分级有明显相关性（P﹤0.05）；病理证实淋巴结转移的癌组织中均有高表达；但原发灶和转移灶之间的表达差异没有统计学意义；实验组与对照组之间差异明显（P﹤0.05）；EGFRvⅢ和CXCR4呈一定的正相关（r=0.144）。结论：EGFRvⅢ和CXCR4促进了晚期HNSCC的侵袭和转移，两者之间有一定的协同作用。