口腔鳞癌中Rb/cyclinD1/p16通路表达及其病理意义

Immunohistochemical Expression of Rb/cyclinD1/p16 Pathway Proteins in Oral Squamous Cell Carcinoma: Correlation with Clinicopathological Features.

目的:探讨口腔鳞癌(OSCC)中Rb/cyclinD1/p16通路表达及其病理意义。方法:使用免疫组化方法在37例OSCC标本中检测Rb、cyclinD1、p16蛋白表达,并与患者临床病理参数进行相关性分析。结果:Rb、p16、cyclinD1阳性表达率分别为76%、49%和57%;Rb和p16表达呈负相关(P=0.02);cyclinD1表达与肿瘤大小(P=0.02)和淋巴结转移(P=0.01)呈正相关;p16表达与年龄呈负相关(P=0.02)。结论:1)OSCC中和Rb和p16之间可能存在的调控机制;2)p16缺失是OSCC发生中的早期事件;3)cyclinD1对肿瘤的生长作用大于对肿瘤的发生作用,与OSCC的增殖和淋巴结转移关系密切,并可能作为标志物对OSCC的预后和转移作出评估。

Objective: To investigate the prognostic value and clinicopathological correlation of tumor Rb, p16 and cycinD1 protein expression in patients with oral squamous cell carcinoma (OSCC). Methods: Immunohistochemical analysis was performed to examine tumor Rb, p16 and cycinD1 proteins level in 37 cases of OSCC, and Fisher' exact test was used to analyze the results with relevant clinicopathological factors. Results: Positive expression of Rb, cyclinD1 and p16 protein were observed in 28/37 (76%),18/37(49%) and 21/37(57%) cases of OSCC, respectively. An inverse correlation was found between p16 and Rb protein level expression statistically ( P =0.02); cyclinD1 over-expression was associated with tumor size ( P =0.02) and lymph node metastases ( P =0.01); Diminished protein level of p16 was detected in the elderly group (over 60 years) as compared with the younger group (less than 60 years) ( P =0.02). Conclusions: 1) The possible interaction between Rb and p16 plays a role in OSCC tumorigenesis, 2) Loss of the p16 protein expression may be the early event in the OSCC development, 3) Over-expression of cyclinD1 might be more correlated to tumor progression than to tumor initiation and critical in tumor cell proliferation and metastasis to lymph nodes. Furthermore, cyclinD1 may be a potential marker clinically as a predictor of lymph node metastases and guide therapeutic strategies in OSCC.