喉癌切缘组织中p53 p21及PCNA表达及其与肿瘤复发的关系

Expression of p53, p21, and PCNA and its correlation with recurrence in the negative surgical margin of early-stage laryngeal cancer

目的:研究早期喉癌手术切缘阴性组织中p53、p21及PCNA表达的相关性及其与肿瘤复发的关系。方法:选取唐山市协和医院2004年1月至2010年12月间92例早期喉癌患者为研究对象,采用免疫组织化学法联合检测肿瘤及其切缘组织中p53、p21及PCNA的表达情况。电话随访2年以上,对患者生存及肿瘤复发情况进行观察。结果:p53、p21及PCNA蛋白在喉癌组织中的表达与肿瘤的分级及分期无关。92例喉癌患者术后2年内有16例出现复发,复发率为17.39%。喉癌阴性切缘复发和未复发标本中p53、p21及PCNA蛋白表达阳性的切缘复发率分别为50.00%、34.21%和33.33%,明显高于p53、p21及PCNA蛋白表达阴性的切缘(8.33%、5.56%和9.68%)。经统计学分析,喉癌复发标本3种蛋白切缘阳性率明显高于未复发标本,均有显著性差异(P<0.01)。此外,喉癌阴性切缘组织中p53与p21蛋白的表达有明显的相关性,PCNA的表达与p21的表达亦有明显的相关性。结论:早期喉癌手术病理阴性切缘组织中的p53、p21及PCNA是患者预后的重要生物学标志,联合检测喉癌切缘组织中p53、p21及PC-NA的表达有望作为预测喉癌复发的指标。

Objective：To explore the correlation among the expression of p53, p21, and PCNA in the negative surgical margin of early laryngeal cancer and its relationship with local recurrence of the cancer. Methods：Data of 92 patients with early laryngeal cancer admitted to the Tangshan Union Hospital from 2004 January to 2010 December were selected. Immunohistochemical method was used to detect the expression of p53, p21, and PCNA in the negative surgical margin tissues of cancer. All patients were followed up for two years to observe survival status and tumor recurrence. Results：The expression of P53, p21, and PCNA had no differences in the cancer tissues in terms of grade and stage. Two years after the surgery, 16 of the 92 patients with laryngeal cancer presented recurrence with a rate of 17.39%. The recurrence rates of expression of p53, p21 and PCNA protein in the positive cut edge were 50.00%, 34.21%and 33.33%, significantly higher than those of negative ones （8.33%, 5.56%and 9.68%）. The positive rates of the three proteins were higher in the recurrence specimen than in the non-recurrence while there was a significant correlation between expression of PCNA and p21 （P〈0.01）. The expression of both p21 and p53 in laryngeal carcinoma was also significantly correlated with the negative margin. Con-clusion：The expression of p53, p21, and PCNA in the surgical margin of early laryngeal cancer are valuable biological markers for the prognosis of these patients. Thus, combined detection of p53, p21, and PCNA in laryngeal margin tissues can be used as a predictive in-dicator of the recurrence.