鼻咽癌CT表现与p53、p16蛋白异常表达关系的研究

Relationship between CT Findings and p53 and p16 Protein Aabnormal Expression of Nasopharyngeal Carcinoma

目的:研究p53、p16蛋白表达与鼻咽癌CT表现的关系。方法:经病理证实鼻咽癌50例,全部病例做鼻咽轴位平扫,部分病例同时做冠状扫描。应用免疫组化SABC法检测所有病例中的p53、p16蛋白的表达。结果:鼻咽癌及鼻咽粘膜慢性炎症中p53蛋白表达率分别为60%和10%,p16蛋白表达率分别为32%和85%,p53、p16表达在两者间的差异有极显著意义(P<0.005)。p53蛋白表达与鼻咽癌分化程度及CT表现为副鼻窦受累,颅底骨质破坏相关(P<0.05)。p16蛋白表达与鼻咽癌预后及CT表现为颈部淋巴结转移相关(P<0.05)。p53与p16有相关性(P<0.005)。结论:p53、p16在鼻咽发生、发展中起重要作用,p53蛋白表达与鼻咽癌分化程度、浸润深度、颅底侵犯有一定相关性,p16蛋白表达与鼻咽癌颈部淋巴结转移和预后有一定相关性,p53、p16可作为评价鼻咽癌CT表现恶性度及预后的指标。

Objective： To study the relationship between the expression of p53 and p16 protein and CT findings of nasopharyngeal carcinoma（NPC）. Mathods： 50 patients of NPC were confirmed by biopsy. Axial CT plain scans in all cases, using 6 - 8mm axial scans with 6 - 8 mm spacing, and coronary slice seaning in some cases were performed. And all cases were examined for expression of p53 and p16 protein by immunohistochemical method. Results： 1. The positive expression of p53 and p16 in nasopharyngeal carcinoma and chronic nasopharyngeal mucosa inflammation were 60% （30/50）, 32% （16/50）, 10% （2/20）, 85% （17/20）. The difference between p53 and p16 expression was significant （p〈 0.005）. 2. p53 protein expression was correlated with histodifferentiation （p〈 0.05）, tumors with undifferentiated cell had strong p53 abnormal expression. 3. No significant difference was found among clinical stages for p53, p16 protein expression. 4. p16 protein expression was correlated with prognosis and cervical lumph node metastasis （p〈 0.05）. 5. p53 protein expression was correlated with aecessory nasal sinuses involvement and skull base destruction （p 〈 0.05）. 6. Relationship was found between p53 and p16 gene expression （p 〈 0.005）. Conclusion： p53 and p16 might play an important role in the pathegesis and development of nasopharyngcal carcinoma, p53 protein expression was correlated with histodifferentiation, invasive depth and skull base destruction; p16 protein expression, prognosis and cervical lumphnode metastasis, p16 and p53 could be served as indicator for predicting prognosis and malignancy of CT findings of nasopharyngeal carcinoma.