p27和p21蛋白在早期喉癌及其切缘组织中的表达与局部复发的关系

Expression of p27 and p21 proteins in laryngeal carcinoma and their relation to local recurrence

目的检测喉鳞状细胞癌、癌旁切缘组织中p27和p21蛋白的表达情况及其与患者预后的关系。方法随机选取2004—2010年间唐山市协和医院85例喉鳞状细胞癌手术切除标本(阴性切缘),同期喉黏膜良性病变79例(慢性炎症12例,喉乳头状瘤67例)作为对照。免疫组化采用SP法。观察喉癌、癌旁组织及喉良性病变中的p27及p21蛋白的表达。收集临床资料并进行随访。结果在随访>2年的喉癌患者中,有14例局部复发(复发组),71例无复发(无复发组)。p27蛋白在喉癌、癌旁组织及喉良性病变中阳性率分别为43.5%、84.7%和89.9%,而p21蛋白阳性率分别为38.8%、21.2%和3.8%。喉癌复发组和无复发组中p27和p21阳性率分别为21.4%和47.9%、85.7%和29.6%,两者差异极显著(P<0.01)。结论 p27和p21蛋白在喉鳞状细胞癌的发生和发展中可能起重要作用;切缘组织中p27失活及p21过表达与喉癌的局部复发密切相关。

Objective To detect the expression of p27 and p21 proteins in laryngeal squamous cell carcinoma （LSCC） and its surgical margins, and to explore the relation of p27 and p21 expression with the local recurrence. Methods Total 85 cases of LSCC with negative surgical margins were randomly selected from 2004 to 2010 in Tangshan Union Hospital; meantime, 12 cases of chronic laryngitis and 67 cases of laryngeal papilloma were used as controls. SP immunohistochemical staining was applied to detect the expression of p27 and p21 proteins in LSCC and its surgical margins as well as controls. Clinical data were collected with follow-up information. Results The two-year follow-up showed that 14 cases of LSCC had the local recurrence and 71 cases had no recurrence. Immunohistochemically, p27 expression was detected in 43.5 % （37/85）LSCC, 84. 7 % （72/85）surgical margins and 89.9 % （71/79 ）controls; the positive rate of p21 expression was found in 38.8% （33/85）, 21.2% （18/85） and 3.8% （3/79）, respectively. By statistical analysis, there was a significant difference in the expression of p27 and p21 between LSCC group and control group （P 〈0. 01 ） ; a significant difference of the protein expression was also existed between LSCCs with local recurrence and without recurrence. Conclusions The expression of p27 and p21 proteins may play an important role in the development of LSCC. Inactivation of p27 and overexpression of p21 are closely associated with the local recurrence of LSCC after surgical removal.