c-FLIP和RECK在喉鳞状细胞癌及癌旁黏膜组织中的表达及其对于喉癌手术切除的意义

The expression of c-FLIP and RECK in laryngeal squamous cell carcinoma and adjacent mucosa and its significance for laryngeal surgery

目的探讨癌基因c-FLIP和抑癌基因RECK在喉癌组织中的表达与喉癌临床特征的关系,了解喉癌的生物学行为,并从细胞和基因水平探讨喉癌手术安全切缘范围。方法分别采用PV9000免疫组化两步法及RT-PCR方法检测38例喉鳞癌组织及距癌组织边缘2 mm、5 mm、10mm组织中c-FLIP和RECK蛋白的表达及mRNA转录情况,同时取距离癌组织边缘15 mm的正常黏膜作为对照。结果(1)c-FLIP和RECK在喉鳞癌组织中的表达水平与患者临床分期和肿瘤病理学分级分别成正相关和负相关。(2)c-FLIP在伴颈淋巴结转移组中的表达水平明显高于非转移组,而RECK则正好相反。(3)c-FLIP表达情况依癌组织→癌旁2 mm→癌旁5 mm→癌旁10 mm→癌旁15 mm黏膜顺序递减,而RECK则递增。c-FLIP和RECK在癌组织与癌旁5 mm、10 mm及正常黏膜组织之间的表达水平有显著性差异(P〈0.05),而与癌旁2 mm处组织之间的差异无统计学意义。结论(1)c-FLIP和RECK两因子在喉鳞癌组织中的表达水平与喉鳞癌患者的临床病理参数密切相关。(2)c-FLlP和RECK可能都参与了喉鳞癌的发生、发展,并与喉鳞癌的浸润及转移有密切关系。(3)c-FLIP和RECK在喉鳞癌组织中及癌旁不同距离组织中的表达情况进一步表明喉鳞状细胞癌手术切除的范围应该包括距离肿瘤边缘5 mm之内的癌旁黏膜组织。

Objective To investigate the relation between expression of c-FLIP and RECK in laryngeal carcinoma and it＇s clinical characteristics and to explore the biological action of laryngeal tumor and the range of safe surgical margin. Methods 38 laryngeal squamons cell carcinoma （LSCC）specimens and different regions adjacent carcinoma （2 mm, 5 mm, 10 mm） were examined for the expression level of c-FLIP and RECK pro- tein by IHC method （ PV9000 ） and RT-PCR was employed to measure the expression of c-FLIP and RECK mRNA. Normal mucosa（ 15 mm） were used for controls. Results The expression of the two cytokines was sig- nificantly associated with clinical staging, pathological grading and cervical lymph node metastasis. The results also showed that the expression of c-FLIP decreased as tissue progressed in sequence from carcinoma tissues to 2 mm, 5 mm, 10 mm distant mucosa adjacent carcinoma and normal mucosa, and the expression of RECK in- creased. The statistical difference between carcinoma tissues and edge group （5 mm, 10 mm, normal mucosa） was significant （P 〈 0. 05 ） respectively, but it was not significant between carcinoma tissues and tissues near the tumor. Conclusions The expression of the 2 cytokines in the tissue of larynx squamous carcinoma is signif- icantly correlated with clinicopathological indexes of the tumor. The 2 cytokines might participate in occurrence and development of larynx squamous carcinoma, c-FLIP and RECK may act as a reference index in judging the biological speciality of LSCC. The expression of c-FLIP and RECK in laryngeal squamous cell carcinoma and adjacent tissues of the distance from laryngeal squamous cell carcinoma indicates that the scope of surgical resection should include the edge of 5 mm from the tumor within the adjacent mucosal tissue.