口腔黏膜鳞癌手术切缘的分子生物学定量研究

Quantitative Molecular Biological Study on Surgical Margins in Oral Squamous Cell Carcinoma

[目的]检测口腔黏膜鳞癌原发灶不同距离外科切缘中p53、CerbB-2、EGFR的表达情况。[方法]采用荧光定量RT-PCR技术检测9例口腔黏膜鳞癌患者术后病理切片阴性、距离切缘1.0cm和1.5cm处的21个标本中p53、CerbB-2、EGFR的mRNA表达水平。[结果]21个标本中,p53、CerbB-2、EGFR的mRNA相对表达量分别为0.71±1.46、4.94±7.76、0.78±1.19,其中CerbB-2的表达量显著高于p53、EGFR的表达(F=5.783,P<0.01)。距切缘距离1.5cm处的CerbB-2表达显著低于距切缘距离1.0cm处的表达(9.38±9.53vs.0.91±1.10,P=0.02),而p53、EGFR表达与手术切缘的距离无显著相关性(P>0.05)。p53、CerbB-2、EGFR表达均与肿瘤分期、患者的年龄无显著性相关(P>0.05)。[结论]临床上通过联合检测口腔鳞癌手术切缘中p53、CerbB-2及EGFR的表达,有助于更好地评估手术切缘的安全性。对于手术切缘组织中CerbB-2高表达的患者,手术切缘大于1.5cm可能更合理。

[Purpose] To investigate the mRNA expression of p53, CerbB-2 and EGFR in vary extent surgical margins of oral squamous cell carcinoma （OSCC）. [Methods ] Twenty-one pathologically negative surgical margins with extent of 1.0cm and 1.5cm to cancer lesion in 9 cases with OSCC were ana- lyzed with the expression of p53, CerbB-2 and EGFR by fluorescent quantitative real-time PCR tech- nique. [Results] The expression of p53, CerbB-2 and EGFR in the 21 margin samples were 0.71± 1.46, 4.94±7.76 and 0.78±1.19, respectively. Of the three markers, the CerbB-2 was significantly overexpressed comparing with the other two （F=5.783,P〈0.01）. The expression of CerbB-2 in the surgical margins with 1.5cm extent was significanthy lower than that with 1.0cm extent （9.38±9.53 vs. 0.91±1.10,P=0.02）. However, the expression of p53 and EGFR didn＇t correlate to margin extent （P〉0.05）. Furthermore, the expression of p53, CerbB-2 and EGFR had no significant relationship with the tumor stage and the patients＇ age （P〉0.05）. [Conclusion] The combined detection of p53, CerbB-2 and EGFR expression may provide more precise clinical evaluation for the surgical margin safety in OSCC. The surgical margin extent to cancer lesion that more than 1.5cm is recommended in patients with high CerbB-2 expression in surgical margin.