口咽鳞癌p16蛋白以及EGFR表达在放疗中的临床意义

The significance of p16 protein and EGFR expression in radiation for oropharyngeal squamous cell carcinoma

目的探索口咽鳞癌患者中p16蛋白状态以及EGFR表达对放疗近期和远期疗效的影响。方法回顾性分析首程治疗为本中心放疗且留存有放疗前肿瘤病理标本的39例口咽鳞癌患者,将患者按照p16蛋白状态和EGFR表达进行分组,比较放疗近期疗效以及总生存情况。结果 39例口咽鳞癌患者以Ⅳ期为主(84.6%),其中23例患者(59.0%)p16蛋白表达阳性。p16(+)者放疗后可以获得更好的肿瘤退缩,而EGFR的表达不同未发现与肿瘤退缩情况相关,多因素分析显示p16蛋白是影响总生存的独立预后因素。结论 p16蛋白阳性的口咽癌患者较阴性者放疗敏感性更高、预后更好,但需要扩大样本量进行验证。

Objective To analyze significance of p16 protein and EGFR expression for prognosis of oropharyngeal squamous cell carcinoma. Method Between 07/31/2002 to 07/31/2012,39 patients of oropharyngeal squamous cell carcinoma, who had received first radiation and retained tumor specimens, were included in retrospective analysis. Immunohistochemical method was used to test status of p16 protein and EGFR expression. Result Most of patients were stage IV （84.6%） ,and 23 patients （59.0%）with p16 positive. EGFR expression （-） , （＋＋） , （＋＋＋） ,and （＋＋＋＋） were observed in 4,12,12 and 11 cases, respectively. The tumors of p16 （＋） shrinked more obviously after radiation than p16 （-） , and p16 was also independently prognostic factor for OS regardless of TN stage ,therapeutic mode and EGFR expression. Notable difference was not detected for tumor shrink or OS according to EGFR expression. Conclusion A group of oropharyngeal cancer patients who were p16-positive had better prognoses in terms of tumor shrink and overall survival than that who were p16-negative ,but large sample research was needed.