颊粘膜鳞癌中p27^(Kipl)基因的蛋白质表达及临床意义

CLINICAL SIGNIFICANCE AND EXPRESSION OF p27^(Kipl) IN BUCCAL MUCOSA SQUAMOUS CELL CARCINOMA

目的 分析口腔颊癌癌变过程中 p2 7蛋白表达与临床病理资料及预后的关系 ,阐明 p2 7蛋白检测在颊癌诊断与治疗中的临床意义。方法 回顾性研究 40例颊癌、2 0例白斑及 7例正常颊粘膜 p2 7蛋白表达情况 ,采用 SP法根据染色指标计数 ,并利用 Cox比例风险模型进行生存多因素分析。结果 p2 7多分布于上皮细胞核和胞浆 ,正常组织和不伴上皮异常增生的白斑表达最强 ,伴上皮异常增生的白斑及颊癌分化较好的强阳性表达较多 ,分化较差的颊癌 p2 7表达最弱 ,甚至不表达。单因素生存分析表明 ,p2 7表达、区域淋巴结和远处转移与生存期显著相关 ,多因素 Cox回归分析表明 p2 7蛋白表达可作为辅助性颊癌预后指标。结论 p2 7蛋白表达与口腔肿瘤的发生发展有密切关系 ,它与肿瘤的侵袭性生长及预后密切相关 。

Objective To study the relationship between the expression of p27 tumor suppressor gene and clinical pathological characteristics or prognosis of buccal mucosa squamous cell carcinoma (BMSC). Methods The expression of p27 in 40 BMSC, 20 leukoplakia, 7 normal oral mucosa specimens was detected by immunohistochemical method. The relation between p27 expression and clinicopathological characteristics or survival time was analyzed by χ 2 test or log rank test, respectively, while univariate and mutivariate prognostic analyses were performed by using Cox's regression model. Results p27 protein staining was confined to the nucleus and (or) cytoplasm. All of normal oral mucosa and leukoplakia without epithelial dysplasia showed strong expression, leukoplakia with epithelial dysplasia and high differentiation BMSC were also detected, but low differentiation often not expressed ( P <0.05). The high p27 expression in BMSC was 52.5%(21/40). Low p27 expression in BMSC was significantly associated with high incidence of lymph node metastasis, local recurrence and distant metastasis ( P <0.05). Log rank test showed that the p27 expression was positively correlated with survival time and Cox's regression indicated that p27 was a prognostic marker of BMSC. Conclusion Low p27 expression was associated with increasing lymph node and distant metastasis and resulted in a poor prognosis with BMSC. So we concluded that assessment of p27 expression was useful as a prognostic factor for BMSC and in selecting aggressive therapy.