p53和Ki-67在老年人口腔癌前病变的表达及临床意义

Expression of p53 and Ki-67 Genes in Epithelial Dysplasia from Old Oral Mucosa and Clinical Significance

目的研究p53、Ki-67蛋白表达与老年口腔粘膜癌前病变的关系。方法采用免疫组织化学LsAB法对60例口腔粘膜上皮异常增生(28例轻度上皮异常增生,32例重度上皮异常增生)和30例正常口腔粘膜p53和Ki-67蛋白的表达进行研究,并对上皮异常增生患者实际癌变率做了5年临床随访。结果在正常粘膜组,p53不表达,Ki-67少量表达;轻度上皮异常增生组,p53、Ki-67少数表达;重度上皮异常增生组,p53和Ki-67过度表达,与正常粘膜组、轻度上皮异常增生组比较差异有统计学意义(P<0.05)。p53和Ki-67蛋白过度表达与实际口腔癌前病变癌变率有一定相关性。结论口腔粘膜癌变是一个由量变到质变的过程,在这一过程中,它们的调控基因p53、Ki-6发生了显著的变化,可能起着重要的调控作用。

Objective To elucidate the relationship between the malignant transformation of oral epithelial dysplasia and the expression of p53 and Ki-67 proteins. Methods The expression of p53 and Ki-67 proteins from 60 cases of oral epithelial dysplasia（28 cases of mild epithelial dysplasia,32 cases of severe epithelial dysplasia） and 30 normal oral mucosa tissue was determined by immunihistochemistry,and a 5-year follow-up study was made. Results In normal epithelium, Ki-67 expression was only observed in a small number of cells, and no expression of p53 was detected. In the cases of mild epithelial dysplasia, low levels of Ki-67 and p53 expression were detected. In the cases of severe epithelial dysplasia, the expression of p53 and Ki-67 protein was significantly higher than that in the normal oral mucosa and in the mild epithelial cases （P〈0.05）. There was a correlation between the malignant transformation and the mutation of p53, Ki-67 in the cases of oral epithelial dysplasia. Conclusion Carcinogenesis of oral mucosa is a continuous and stepwise course; p53 and Ki-67 genes may play an important role in this course.