颊癌P16及P53蛋白表达与临床病理的相关研究

Correlation between expression of p53,p16 and clinicopathological feature of buccal cancer

目的探讨P16和P53在口腔颊癌中的表达特点及其与临床病理的关系。方法采用免疫组化和图像分析技术,检测32例颊粘膜白斑和扁平苔藓,30例颊癌和10例正常颊粘膜组织中P16和P53蛋白的表达水平。并将结果与病理分级、临床分期、癌转移等指标进行统计分析。结果正常颊粘膜、单纯性增生、不典型增生、颊癌中P16表达的阳性率分别为：100%、100%、90%、40%；P53表达的阳性率依次为：0、4．5%、25．5%、53．3%。颊癌P16的表达率比上皮不典型增生明显降低(P＜0．05)。颊癌P53的表达率比上皮单纯性增生明显升高(P＜0．05)。临床Ⅰ、Ⅱ期病例中P16蛋白表达水平高于Ⅲ、Ⅳ期的病例(P＜0．01)。无颈淋巴结转移病例中,P16蛋白表达水平高于有转移的病例(P＜0．05)。病理分级为Ⅰ级的病例,P53蛋白表达水平明显低于Ⅱ、Ⅲ级的病例(P＜0．01)。临床Ⅰ、Ⅱ期病例中,P53蛋白表达水平低于Ⅲ、Ⅳ期者(P＜0．05)。无颈淋巴结转移病例中,P53蛋白表达水平低于有转移的病例(P＜0．05)。P16阳性组中,P53的表达显著低于P16阴性组(P＜0．05)。结论颊癌早期P53蛋白有过度表达。P16低表达和P53高表达时提示颊癌预后较差。P16和P53蛋白的联合检测可作为临床评估颊癌浸润、转移和预后的参考指标。

Objective To investigate the relationship between the expression of p16 and p53 proteins and the clinicopathological feature of buccal cancer. Methods The immunohistoehemical stains against p16 and p53 protein was performed to determine expression of oncogene in 30 cases of buccal cancer, 32 cases of buccal leukoplakia and buccal lichen planus and 10 cases of normal buccal mucos. All results were analyzed quantitatively by imagine analysis technique. Then, the results were compared with clinico - pathological parameters. Results The positive expression of p16 protein in normal buccal , hyperplasia, atypical hyperplasia, buccal cancer was 100.0%, 100.0%, 90.0%, and 40.0% , while the positive expression of p53 protein was 0, 4.5%, 25.0%, 53.3%. The positive expression rate of p16 protein in buccal cancer was significantly lower than that in atypical hyperplasia （ P 〈 0.05）. The positive expression rate of p53 protein in buccal cancer and atypical hyperplasia were significantly higher than that in hyperplasia （ P 〈 0.05）. The expression of P16 in stage Ⅰ and Ⅱ was significantly higher than that in stage m and Ⅳ （ P 〈0.01） , while expression of P16 in cases without lymph node metastasis was much higher than that in cases with lymph node metastasis （ P 〈 0.05）. The expression of P53 in grade Ⅰ was significantly lower than that in grade Ⅱ and m （ P 〈 0.01 ）. Meanwhile, the expression of P53 in stage Ⅰ and Ⅱ was significantly lower than that in stage m and Ⅳ （ P 〈 0.05）, while expression of p53 in cases without lymph node metastasis was much lower than that in cases with lymph node metastasis （ P 〈0.05）.Conclusion P53 protein could over express in the early stage of buccal cancer. Negative expression of p16 and over expression of P53 in buccal cancer could also predict a poor prognosis. The expressions of p16 and p53 protein could be used as a marker for evaluating clinical stages and metastasis in buccal cancer.