p16和p53蛋白在口腔白斑和鳞状细胞癌中表达的比较研究

Comparative study on the expression of p16 and p53 protein in leukoplakia and oral squamous cell carcinoma

目的比较p16和p53在口腔白斑和口腔鳞状细胞癌中异常表达的情况。方法对17例健康者的口腔粘膜、60例白斑患者和40例口腔鳞状细胞癌患者的病损组织进行了p16和p53蛋白的免疫组化染色。结果正常口腔粘膜、白斑单纯增生、白斑异常增生和口腔鳞状细胞癌的p16阳性率分别为100%、90%、60%和35%,p53蛋白的阳性率分别为12%、27%、50%和73%,p16阳性率和细胞染色强度指数(stainning intensity index,SII)分别与口腔粘膜组织恶性度的增高显著负相关;p53阳性率和SII分别与口腔粘膜组织恶性度的增高显著正相关。p16和p53在不同组织中的阳性率显著负相关;p16和p53在白斑异常增生的协同失活率达23%,在口腔鳞状细胞癌中达到42.5%。p16阳性率、p16SII、p53SII及两种基因均异常的比率在口腔鳞状细胞癌无淋巴结转移和口腔鳞状细胞癌有淋巴结转移患者之间均有显著差异。结论p16可作为早期监视口腔白斑恶变、监测口腔鳞状细胞癌发展进程和判断口腔鳞状细胞癌预后的分子生物学指标。p16和p53失活在白斑癌变和口腔鳞状细胞癌的发展过程中可能有叠加效应。

Objective To compare the expression of p16 and p53 in leukoplakia and oral squamous cell carcinoma （OSCC）.Methods Clincial specimens were obtained from 17 normal individuals, 60 patients with leukoplakia and 40 patients with OSCC for the p16 and p53 immunochemical stain study. Results Positive rates of p16 expression in normal mucosa, hyperplasia, dysplasia and OSCC were 100% ,90% ,60% and 35%. Positive rates of p53 were 12% ,27% ,50% and 73%. Both positive rates and stainning intensity index （SII） of p16 were negatively correlated to malignancy of oral epithelial tissue. Whereas both positive rates and stainning intensity index （SII） of p53 were positively correlated to increasing malignancy of oral epithelial tissue. Positive rates of p16 in different epithelial tissue were negatively correlated to those of p53. The coordinate inactive rate of p16 and p53 was 23% in dysplasia and 42.5% in OSCC. There were significant differences in the positive rate and SII for p16, SII for p53, and the rates of two gene inactivation between with lymph node metastasis and witbout lymph node metastasis. Conclusion The study suggests that p16 can be used as a molecular biornarker for early detection of leukoplakia cancerization, indication of OSCC progression and evaluation of prognosis. The inactivation of two genes may play a superposed role in leukoplakia cancerization and OSCC progression.