喉癌组织及手术切缘P53和P16蛋白表达与局部复发的关系

The status of protein P16 and P53 in the surgical margins of laryngeal carcinoma and the association with local recurrence

目的 用免疫组织化学方法监测P16和P5 3蛋白在喉癌手术切缘中的表达情况及其与肿瘤局部复发的关系。方法 选择HE染色病理学检查手术切缘为阴性但术后肿瘤局部复发的 5 2例喉癌作为复发组 ,并按照患者的年龄、性别、临床分型、TNM分期、病理分级、术前放疗剂量等可能影响因素选择 48例随访 5年以上无肿瘤局部复发者为无复发组。对 2组手术切缘和肿瘤标本同时行P16和P5 3蛋白免疫组织化学检查。结果 在 10 0例喉癌组织中P5 3蛋白的表达率和P16蛋白的丢失率分别为 5 4%和 40 % ,喉癌组织中P16和P5 3蛋白表达同时异常的喉癌患者当其手术切缘粘膜中P16和P5 3蛋白表达也同时异常时 ,其术后肿瘤局部复发率为 85 %。P16和P5 3蛋白表达与喉癌的临床分型和T分期无关。结论 采用免疫组化方法联合检测P16和P5 3蛋白在喉癌组织和手术切缘中的表达情况可为筛选术后肿瘤局部复发的高危病例提供依据。

Objective To assess the status of P53 and P16 of surgical margins in laryngeal carcinoma and the association with the local recurrence following surgical treatment Methods The status of P53 and P16 of surgical margins in laryngeal carcinoma was studied using immunohistochemistry (IHC) staining method in 100 cases of laryngeal carcinoma. Fifty-two of them had recurrent tumors while 48 cases were free of local recurrence after 5-year follow up. The original tumor sites and T stages, which bear important influence over the risk of local recurrence, were strictly matched between the two groups, and the ages and preoperative doses of radiation were also considered. Results The percentage of local recurrence was 85% in these patients who showed positive staining for P53 and simultaneous negative staining for P16 in both the cancer tissues and the surgical margins. No association was found between the expression of P53 and P16 and the clinical types or T stages. Conclusion The status of P53 and P16 in combination demonstrated by IHC technique in surgical margins of laryngeal carcinoma may predict the possibility of local recurrence.