喉癌p16、c-myc及PCNA表达的临床病理研究

Clinicopathological Study of p16, c - myc and PCNA Expression in Laryngeal Cancer

探讨ｐ１６、ｃ－ｍｙｃ及ＰＣＮＡ在喉癌发病中的作用。方法：应用ＳＡＢＣ免疫组化技术，检测４０例喉鳞癌手术标本中ｐ１６、Ｃ－ｍｙｃ及ＰＣＮＡ的表达，对三者表达与喉癌发生部位，临床分期。组织学分级和临床复发之关系进行探讨。结果：①ｐ１６阳性表达多见于高分化组和未复发组，阴性多见于低分化组和复发组病例；②Ⅲ、Ⅳ期的ｃ－ｍｙｃ得分显著高于Ⅰ、Ⅱ期得分；③Ⅲ、Ⅳ期，低分化，复发组的ＰＣＮＡ指数分别高于Ⅰ、Ⅱ期，高分化，未复发组的指数；④ｃ－ｍｙｃ得分与ＰＣＮＡ指数呈正相关。结论：ｐ１６、ｃ－ｍｙｃ及ＰＣＮＡ表达与喉癌临床病理指标有关，喉癌的发生与演进是多因素作用的结果，三种检测对估计喉癌的恶性度、判断预后及指导治疗有重要意义。

Objective: To explore the potential role of p16, c - myc and PCNA in the genesis andprogression of laryngeal cancer. Methods: Using immunohistochemical staining technique, 40 cases oflaryngeal cancer specimens were examined for expression of p16, c - myc and PCNA protein. The relation-ship between the immunoreactivity of p16, c - myc, PCNA and the site of tumor, clinical stage, differentia-tion grading and clinical recurrence were analysed. Results: 1) The expression of p16 correlated with thedifferentiation grading and clinical recurrence. The majority of high differentiation grading and recurrentgroup were positive for p16 which was negative in most of the low differentiation grading and recurrentgroup (P<0.005, P<0.005) . 2) There was significant correlation between c - myc expression andclinical stage. The c - myc scores of late stage patients were higher than those in the early stage pa-tients ( P < 0. 001 ). 3) The PCNA expression correlated with the clinical stage, differentiation gradingand clinical recurrence. The PCNA index of III, IV stage were higher than those of I, II stage ( P <0. 001 ) . The PCNA index of recurrent group was higher than that of patients with no recurrence ( P <0. 01 ) . The PCNA index increased with the downgrading of differentiation ( P < 0. 01 ) . 4)There waspositive correlation between c - myc score and PCNA index. Conclusion: The expression of p16, c -myc and PCNA closely correlate with the clinicopathological parametero of laryngeal cancer. The gene-sis and progression of laryngeal cancer is a multi - factor and multi - step process. Detection of theabove parameters is of some inferential value in predicting biological aggressiveness and clinical out-come of laryngeal cancer and it may guide to make therapeutic decision.