鼻咽癌组织中P16、CD4和CD8的表达及其与预后的关系

Clinical significance of P16,CD4 and CD8 in nasopharyngeal carcinoma

目的探讨鼻咽癌组织中P16、CD4和CD8的表达及其与鼻咽癌患者临床特点及预后的关系。方法采用免疫组化法检测133例鼻咽癌组织中P16、CD4和CD8的表达情况,分析其表达与鼻咽癌临床病理特征及预后的关系。结果133例鼻咽癌组织中,P16的阴性表达率为75.9%(101/133),阳性表达率为24.1%(32/133);CD4的阴性表达率为75.2%(100/133),阳性表达率为24.8%(33/133);CD8阴性表达率为76.7%(102/133),阳性表达率为23.3%(31/133)。P16与CD4在鼻咽癌组织中的表达差异有统计学意义(P<0.05),二者呈正相关趋势(r=0.206,P=0.094);P16、CD4和CD8在不同性别、年龄、民族、吸烟史、肿瘤家族史、临床分期患者中的表达差异均无统计学意义(P>0.05),但P16表达在不同性别患者(P=0.069)、CD8表达在不同临床分期患者(P=0.085)中的差异均为临界值;P16、CD4、CD8阴性表达和阳性表达患者5年总生存率差异无统计学意义(P>0.05),但CD4阳性表达与阴性表达患者5年无瘤生存率(P=0.002)及5年无局部复发生存率(P=0.024)差异均有统计学意义。结论 P16、CD4和CD8表达与鼻咽癌患者性别、临床分期有关。CD4阳性表达患者预后可能更佳,联合检测P16、CD4和CD8在鼻咽癌中的表达或可作为判定鼻咽癌患者生物学行为及预后评估的依据。

Objective To examine the clinical significance of P16, CD4 and CD8 in patients with nasopharyngeal carcinoma. Methods Clinical history and immunohistochemical expression of P16,CD4 and CD8 were investigated in 133 patients with nasopharyngeal carcinoma. Results Negative expression rates were 75.9% for P16,75.2% for CD4 and 76.7% for CD8 ;the corresponding positive expression rates were 24.1%,24.8% and 23.3%. Expression of P16 positively correlated with that of CD4 （P〈0.05）. Expression of P16,CD4 or CD8 did not differ significantly with gender,age,nationality,smoking history,family history of cancer or clinical stage. Nevertheless, trends were observed for gender-dependent expression of P16（P=0.069） and clinical stage-dependent expression of CD8 （P=0.085）. Patients negative or positive for expression of P16,CD4, or CD8 did not differ significantly in 5-year overall survival rate （P〉0.05）. However, CD4 positivity was associated with significantly higher rates of 5-year disease-free survival （P=0.002） and 5-year local recurrence-free survival （P=0.024） than CD4 negativity. Conclusion P16,CD4 and CD8 expression is associated with the clinical characteristics of nasopharyngeal carcinoma. CD4-positive patients may have better prognosis. Joint detection of P16,CD4 and CD8 expression in nasopharyngeal carcinoma may help guide classification,treatment and prognosis prediction of patients.