喉癌手术安全切缘的免疫组化研究

Immunohistochemical study of safe resection margin in the surgical treatment of laryngeal carcinoma

目的：从基因蛋白水平角度研究喉癌手术安全切缘。方法：应用 Ｌ Ｓ Ａ Ｂ免疫组化法，检测了ｒａｓ、ｃｍ ｙｃ、ｐ５３ 癌基因在３０ 例喉癌，边缘区，癌旁０．５、１．０、１．５、２．０ ｃｍ 粘膜处和 ４ 例正常喉粘膜中的表达情况。结果：三种癌基因产物的单独及联合表达阳性率依正常粘膜→癌旁２．０ ｃｍ →１．５ ｃｍ →１．０ ｃｍ →０．５ ｃｍ →边缘区→癌顺序递增，且癌基因蛋白的表达在距肿瘤０．５ ｃｍ 以内的癌旁组织与癌旁组织１．０ ｃｍ 处有显著性差异（ Ｐ ＜ ０．０５）。结论：距肿瘤０．５ ｃｍ 内的癌旁组织应视为癌前期病变，以切缘距肿瘤０．５ ｃｍ

Objective:To study safe resection margin of laryngectomy according to the level of protein of gene expression.Method:Using citric LSAB immunochemical technique,the expressions of ras、c myc and P53 were studied in different regions of larynx including 30 cases laryngeal carcinoma、border area、adjacent mucosa which was 0.5 、 1.0 、 1.5 、 2.0 cm away from cancer and four normal laryngeal mucosa.Result:The results showed that both single expression and co expression of p21,p62 and p53 increased as tissue progressed in sequence from normal mucosa、 2.0 、 1.5 、 1.0 、 0.5 cm distant mucosa adjacent to carcinoma、border area and carcinoma.A significant different expression in most of them can be seen at regions of 0.5 cm and 1.0 cm distant from the tumor (P< 0.05 ).Conclusion:The tissue 0.5 cm adjacent to the tumor should be regarded as precancerous lesion.It is appropriate to regard 0.5 cm away from tumors as resection margins for surgical treatment of laryngeal carcinoma.