头颈鳞癌p53、Bcl-2及P-gp表达在治疗中的作用

Effect expression of p53,Bcl-2 and P-gp protein in treatment head and neck squamous carcinoma

目的检测突变型p53、Bcl-2及P-gp蛋白在头颈鳞癌中的表达,探讨其在治疗中的作用。方法97例头颈鳞癌中口咽癌18例、下咽癌27例、声门上喉癌52例,采用S-P法检测癌组织中p53、Bcl-2及P-gp蛋白表达,并结合治疗结果进行统计分析。结果突变型p53、Bcl-2及P-gp蛋白在头颈鳞癌中的阳性表达率分别为69.07%、46.39%、50.52%。突变型p53蛋白阳性与阴性累计五年生存率分别为38.43%和75.86%。P-gp蛋白阳性与阴性分别为35.23%和63.15%,两者对比有统计学意义(P<0.05)。在单纯手术和术后放疗、化疗两组中,突变型p53蛋白阳性与阴性的五年生存率分别为40.77%和80.00%、25.63%和61.90%,对比均有统计学意义(P<0.05)。术后放疗、化疗组中Bcl-2和P-gp蛋白阳性与阴性的五年生存率分别为23.35%和48.83%、31.43%和60.53%,差别有统计学意义。结论突变型p53、Bcl-2、P-gp蛋白阳性表达是抵抗放疗或化疗的生物学指标,在预测放疗、化疗敏感性方面有一定作用。

Objective To detect expression of mutational p53, Bcl-2 and P-gp protein in head and neck squanlous cancer, and to approach the effect of that. Methods Among 97 cases of head and neck squa- mous careinomas, oropharyngeal cancer were 18 cases, hypopharyngeal cancer 27 cases, superglottic laryngeal cancer 52 cases. PS methods were used to detect the expression of p53, Bcl-2 and P-gp protein in squamous cancer. Statistical analysis was performed with treatment results. Results The positive rate of mutational p53, Bcl-2 and P-gp proteins in head and neck squamous cancer were 69.07% ,46.39% and 50.52% respectively. 5 years accumulative survival rates of positive and negative rates of mutational p53 were 38.43% and 75.86% respectively. 5 years accumulative survival rates of positive and negative rates of mutational P-gp protein were 35.23% and 63.15% respectively. Their comparison between 5 years accumulative survival rates had remarkable difference （ P 〈 0.05）. In surgical and postoperative radiotherapy of chemotherapy groups, 5 years survival rates of positive and negative mutational p53 protein were 40.77% and 80.00%, 25.63% and 61.90%, respectively. Their comparison between positive and negative expression had statistical significance （ P 〈 0.05）. In postoperative radiotherapy and chemotherapy group, 5 year survival rates of positive and negative Bcl-2 and P-gp protein were 23.35 % and 48.83 %, 31.43 % and 60.53 % respectively, and had statistical significance. In positive expression of Bcl-2, the rate of lymph node metastasis was 68.89 %. Conclusion The positive expression of mutational p53 , Bcl-2 and P-gp are biological index of resisting radiotherapy or chemotherapy, and play some role in calculating sensitivity of radiotherapy and chemotherapy.