头颈胸鳞状细胞癌组织EB病毒基因表达与临床病理特征的相关性

Correlation between EB Virus Gene Expression and Clinicopathological Features inHead,Neck and Chest Squamous Cell Carcinoma

【目的】分析发生在头颈和胸部的鳞状细胞癌组织中EB病毒的表达情况,并分析其临床病理学特征。【方法】收集头颈胸鳞状细胞癌组织123例,利用原位杂交技术和免疫组织化学SP法检测EBV及Ki67蛋白的表达,结合临床病理学资料(性别、年龄、组织学分级、淋巴结转移、远处转移、肿瘤部位及肿瘤直径)进行回顾性分析。【结果】EBV阳性表达率在癌组织明显高于正常粘膜上皮组织(P=0.007)。女性患者EBV感染率19.2%高于男性患者3.1%(χ^2=8.781,P=0.011);50岁以下组EBV感染率18.8%高于50岁以上组2.2%(χ^2=10.666,P=0.004);有5~10个淋巴结转移组EBV感染率24.2%高于其他组0%(Z=-3.548,P=0.000);无远处器官转移组EBV感染率22.2%高于有远处转移组3.8%(χ^2=8.567,P=0.016);Ki67增殖指数在70%以下组较70%以上组的EBV阳性率更高(8/76 vs.0/47,Z=-2.291,P=0.022)。EBV感染阳性组和阴性组在组织学分化、肿瘤部位、肿瘤直径方面的差异没有统计学意义。回归分析结果显示年龄小于50岁、Ki67指数低于70%和高淋巴结转移为鳞癌患者伴EBV感染的高危因素。【结论】EBV感染与头颈胸鳞癌的发生有关。EB病毒相关的头颈胸鳞癌多发生于女性、50岁以下且淋巴结转移率高,但远处器官转移少见。

【Objective】To study the expression of EB virus gene in head,neck and chest squamous cell carcinoma(HNCSCC),revealing the clinicopathological significance.【Methods】Using in situ hybridization and S-P immunohisto⁃chemical technique,we examined the expression of EBV and Ki67 protein in 123 cases of HNCSCC.The pathological characteristics such as sex,age,histologic grade,lymph node metastasis,distant metastasis,situation and size were analyzed retrospectively.【Results】The positive expression rate of EBV in HNCSCC group was significantly higher than that in the normal mucosal epithelial group(P=0.007).EBV positive HNCSCC in female patients was 19.2%,markedly higher than 3.1%in male patients(χ^2=8.781,P=0.011).EBV positive HNCSCC in the group under 50 years old was 18.8%(6/32),significantly higher than 2.2%in the group over 50 years old(χ^2=10.666,P=0.004).The infection rate of EBV was 24.2%in 5~10 lymph nodes metastasis groups,significantly greater than other groups 0%(Z=-3.548,P=0.000).EBV infection rate in the group without distant organ metastasis was 22.2%,higher than 3.8%with distant organ metastasis(χ^2=8.567,P=0.016).The group with the Ki67 proliferation index less than 70%showed higher positivity of EBers than the group with Ki67 more than 70%(8/76 vs.0/47,Z=-2.291,P=0.022).There were not any statistically significant differences in histological differentiation,tumor situation and tumor diameter between EBV positiveand negative groups.Regression analysis showed that age below 50 years old,the Ki67 index less than 70%and the morelymph node metastasis was elevated risk factors for EBV infection.【Conclusion】EBV infection is associated with HNC⁃SCC.EBV-associated HNCSCC is more frequent in female patients under 50 years of age with more lymph node metasta⁃sis,while distant metastasis is less common.