鼻腔鼻窦恶性肿瘤p53基因突变的检测及临床意义

Experimental studies and clinical significance of p53 gene mutation in carcinomas of the nasal cavity and paranasal sinuses

应用聚合酶链反应-单链构象多态性分析（PCR－SSCP）方法，检测21例鼻腔易窦恶性肿瘤新鲜及石蜡包理组织中，p53基因第6外显子的突变率发现p53基因第6外显子突变14例，突变率为67％。其Ⅰ～Ⅳ期的分布分别为33％（1／3）、50％（3／6）、67％（4／6）、100％（6／6）；其分化程度分布为33％（2／6）、67％（4／6）、89％（8／9）；有淋巴结转移者为100％（4／4），无转移为59％（10／17）。经χ2检验，差异均无显著意义，但其突变率有随临床分期的增加、肿瘤分化程度的降低及淋巴结转移而呈升高趋势。提示该检测方法敏感快速，对判断鼻腔鼻窦肿瘤恶性度及估计预后有参考意义。

By using PCR-SSCP method, 21 specimens of nasal cavity and paranasal sinuses carcinomas which were freshly frozen and paraffin embedded were detected for the mutation of p53 gene(exon 6). The overall mutation frequency of patients was 67 % (14 out of 21 ),which was 33% (1 out of 3),50% (3 out of 6), 67% (4 out of 6)and 100% (6 out of 6) respectively in clinical stage Ⅰ to Ⅳ, 33% (2 out of 6), 67 % (4 out of 6) and 89 % (8 out of 9) respectively in well,moderately and poorly differentiated carcinomas,and 100% (4 out of 4) and 59 % (10 out of 17 ) respectively in lymph-node metastasis and non-lymphnode metastasis. It was not statistically significant when the Chi-square test was applied(P>0.05),but there was a tendency towards an increase in p53 mutation frequency with highly malignant,poorly differentiated and lymph-node metastasis carcinomas.The results indicate that the mutation of p53 gene plays an important role in the initial and progression of nasal cavity and praranasal sinuses carcinomas.Detection of p53 mutation using the above sensitive and rapid method reveals practical significance for judging malignant level and evaluating prognosis of nasal cavity and paranasal sinuses carcinomas.