免疫组化检测对喉癌手术切缘的安全性研究

The immunohistochemistry and clinic study on surgical margin of laryngeal cancer

目的：探讨从细胞的蛋白水平确定喉癌手术的安全切缘范围。方法：采用免疫组化LSAB或SABC方法，对36例原发性喉癌的三组标本（喉癌组，近癌旁组，远癌旁组）行5种抗体（p16、p21，TGF-β1，PCNA，EGFR）检测。结果：5种抗体在喉癌组表达阳性率分别与两边缘组阳性率差异非常显著（P＜0．01）或差异显著（P＜0．05），而近癌旁组与远癌旁组阳性率之间差异均无显著差异（P＞0．05），5种抗体在高分化组与低分化组阳性率差异显著（均为P＜0．05），PCNA在是否有颈淋巴结转移组之间的阳性率表达差异显著（P＜0．05）。全部病例手术切缘大于5mm，复发率3％。结论：结合临床从细胞的蛋白水平证实喉癌的手术切缘5mm是安全的。

Objective:To probe into the safe incisal range of removing largngectomy cancer determined fromthe albumen balance of cells. Method: LSAB or SABC of immunohistochemistry was applied,and three groups ofsamples with cancer tissue, nearby cancer tissue and distal cancer tissue of 36 primary largngectomy cancer weretested by antibodies p16,p21,TGF-β1, PCNA and EGFR. Result:The difference of the positive rate with the fiveantibodies between the cancer group and the two side incisal group were very notable with P <0. 01 or P <0. 05,but whih between nearby cancer tissue and distal cancer tissue were not notable with P >0. 05. The differencesof the positive rates with 5 antibodied between high differentiation group and low differentiation group were no-table with P <0. 05,and P <0. 05 with PCNA in the group whether the lymphonodi cervicales transndtted ornot. The incisals for all the cases are beyond 5 mm,the recurerence rate is 3%. Conclusion:the 5 mm incisal forlaryngectomy cancer is appropriate on the albumen cevel of cells.