鼻咽癌P16和nm23-H_1蛋白表达及其与临床的相关性

Expressions of P16 and nm23-H_1 in nasopharyngeal cacinoma and their clinical significance

目的观察P16、nm23-H1基因产物在鼻咽癌(NPC)中的表达状态,探讨其与NPC的转移及外周血T淋巴细胞核仁形成区嗜银蛋白(AgNORs)水平的关系。方法采用SP免疫组织化学方法检测65例NPC初治患者癌组织中P16、nm23-H1基因产物表达,并对治疗前患者外周血T细胞AgNORs含量进行检测。结果鼻咽癌组织中P16、nm23-H1蛋白表达率分别为24.6%(16/65)和61.5%(40/65)。T1和T2期患者P16及nm23-H1蛋白表达高于T3及T4期患者,但无显著性差异(P>0.05)。P16蛋白表达与有无颈淋巴结转移及放疗后远处转移无关(P>0.05);nm23-H1蛋白在有颈淋巴结转移的患者中表达率为51.2%(21/41),低于无颈淋巴结转移者的79.2%(19/24)(字2=4.99,P<0.05);随访中有15例发生远处转移,其nm23-H1表达率为33.3%(5/15),显著低于无转移组的70%(35/50)(字2 =7.56,P<0.01)。P16、nm23-H1蛋白表达阳性患者外周血T细胞AgNORs含量显著高于阴性者(P<0.01)。结论nm23-H1基因表达与鼻咽癌转移相关,可以用于临床预测鼻咽癌发生局部淋巴结转移和放射治疗后远处转移。nm23-H1、P16基因表达与外周血T细胞核仁组成区形成有关,可能反映了机体的免疫调节机能。

Objective To examine the expressions of P16 and nm23-H1 protein in nasopharyngeal carcinoma (NPC) and explore their association with clinicopathology and the level of argyrophilic protein of the nucleolar organizer regions (AgNORs) of peripheral blood T lymphocyte (T-AgNORs) before radiotherapy. Methods SP immunohistochemistry was used to detect P16 and nm23-H1 expressions in 65 cases of NPC, and the level of T-AgNORs was measured before radiotherapy. Results The positivity rate of P16 and nm23-H1 protein in NPC was 24.6% (16/65) and 61.5% (40/65), respectively. The positivity rates of P16 and nm23-H1 protein in patients in T1 and T2 stages were higher than those in patients in T3 and T4 stages, but the difference was not statistically significant (P>0.05). No significant association of P16 expression was noted with lymph node metastasis and post-radiotherapy distant metastasis (P>0.05). In patients with regional lymph node and distant metastases, the positivity rates for nm23-H1 were 51.2% (21/41) and 33.3% (5/15), which were significantly lower than those in patients without local lymph node (79.2%, 9/24; ?字2= 4.99, P<0.05) or distant metastasis (70%, 35/50; ?字2=7.56, P<0.01). The levels of T-AgNORs in P16- and nm23-positive cases were higher than those in the negative cases (t=5.721, P<0.001). Conclusions nm23-H1 expression in NPC tissue is correlated with NPC metastasis and may be useful for clinical prediction of local lymph node and distant metastases after radiotherpay. nm23 and p16 expressions are also correlated with the level of T-AgNORs, which probably indicate the immune functions of the patients.