喉癌与手术切缘组织PCNA和Cdc2表达与局部复发相关性研究

Relationship between expression of PCNA and Cdc2 and local recurrence of tumor in early laryngeal cancer with negative surgical margins

目的研究早期喉癌手术切缘组织学检测癌阴性组织PCNA和Cdc2表达与肿瘤局部复发的关系。方法选取2004-01-01-2010-12-31唐山市协和医院85例早期喉癌患者作为研究对象,采用CO2激光手术治疗并进行回顾性研究。采用免疫组织化学方法(SP)对肿瘤及其切缘组织中PCNA和Cdc2的表达进行检测。所有患者均随访>2年,对其生存及肿瘤局部复发情况进行观察。结果85例喉癌患者中有14例局部复发(复发组),71例未复发(未复发组)。85例患者肿瘤组织中PCNA阳性表达率为72.94%(62/85),Cdc2阳性表达率为70.59%(60/85)。肿瘤组织PCNA的表达与喉癌的分化程度(χ2=0.001,P=0.979)及分期(χ2=0.132,P=0.716)差异无统计学意义;Cdc2的表达与喉癌的分化程度(χ2=1.803,P=0.179)及分期(χ2=0.232,P=0.630)差异无统计学意义。切缘组织中PCNA和Cdc2阳性率分别为32.94%(28/85)和29.41%(25/85)。局部复发率为16.47%(14/85),喉癌复发组切缘组织中PCNA和Cdc2蛋白表达阳性率分别为64.28%(9/14)和26.76%(19/71);未复发组分别为57.14%(8/14)和23.94%(17/71)。经统计学处理,喉癌复发组织PCNA和Cdc2蛋白阳性表达率差异有统计学意义,χ2=7.454,P<0.01;未复发组阴性切缘组织中阳性表达率差异有统计学意义,χ2=6.208,P<0.05。结论早期喉癌阴性手术切缘组织中PCNA和Cdc2的表达是预测术后复发的重要生物学标志,癌切缘组织PCNA和Cdc2蛋白联合检测癌阴性组织对判断早期喉癌术后是否发生局部复发具有一定价值。

OBJECTIVE To explore the relationship between expression of PCNA and Cdc2 in the early laryngeal cancer with negative surgical margins and the local recurrence of tumor. METHODS Totally 86 cases of laryngeal squa- mous cell carcinoma with negative surgical margins were randomly selected from January 1, 2004 to December 31, 2010 in Tangshan Xiehe Hospital. CO2 laser surgery were adopted as treatment and all of the 85 cases were taken into retrospec- tive cohort study. The expression of PCNA and Cdc2 was detected in the tumor tissue and surgical margins. All patients were followed up for more than two years to observe the survival rate and local recurrence. RESULTS The two-year fol- low-up showed that 14 cases of laryngeal squamous cell carcinoma had the local recurrence while 71 cases had not. The expression rates of PCNA and Cdc2 in the 85 early laryngeal cancer tissues were 72.94% （62/85） and 70.59% （60/86） There was no significant difference between expression of PCNA and Cdc2 in tumor tissue and differentiation degree and tumor staging （x^2=0. 001,P=0. 979, x^2=0. 132,P=0. 716, x^2 =1. 803,P=0. 179, 7.2 =0. 232,P=0. 630） ;The posi- tive rates of PCNA and Cdc2 in the surgical margin tissues were 32.94% （28/85）, 29.41% （25/85）, respectively. Fol- low-up data showed that 14 cases had the local recurrence, accounting for 16.47%. The expression rates of the PCNA and Cdc2 proteins in the recurrence group and non-recurrence group were 64.28% （9/14）, 26.76% （19/71） and 57.14% （8/14）, 23.94% （17/71）, respectively. Statistical analyses showed that the marginal positive rate between the recurrence group and non recurrence group had significant difference （x^2=7. 454,P〈0.01;x^2 = 6. 208,P〈0.05）. CONCLUSIONS The expression of PCNA and Cdc2 in surgical margins of early taryngeal cancer is an important biological marker for e- valuation of local recurrence. Combined detection of PCNA and Cdc2 in negative surgical margins of early laryngeal cancer has certain value to determine postoperative local recurrence of tumor.