口腔鳞癌中p53、Bcl-2、E-Cadherin以及Ki-67表达与临床病理参数及预后的关系

P53,Bcl-2,E-Cadherin and Ki-67 expression and clinicopathological characteristics in oral squamous cell carcinoma:Significance to prognosis

目的:探讨p53、Bcl-2、E-Cadherin以及Ki-67蛋白在口腔鳞癌中的表达情况,与临床病理相关关系及其预后意义。方法:收集116例手术切除的口腔鳞癌组织,采用免疫组化法检测肿瘤组织中p53、Bcl-2、E-Cadherin、Ki-67蛋白的表达。分析各蛋白的表达以及临床病理特征的相关性,Kaplan-Meier、Cox回归分析患者预后。结果:P53、Bcl-2、E-Cadherin蛋白在肿瘤中的表达率分别为75%(87/116)、19.8%(23/116)、91.4%(106/116);Ki-67蛋白在肿瘤中阳性表达率<50%为31.0%(36/116),≥50%为69.0%(80/116)。P53的表达与肿瘤原发部位、神经浸润情况密切相关(P<0.05),E-Cadherin的表达与肿瘤原发部位、神经浸润情况密切相关(P<0.05),Ki-67的表达与浸润前沿的情况、神经侵犯密切相关(P<0.05)。Kaplan-Meier分析结果显示,p53、E-Cadherin阳性组OSCC患者3年总生存率低于阴性组,且差异具有统计学意义(P<0.05);Ki-67高表达组OSCC患者3年总生存率低于阴性组(P<0.05)。Cox回归模型结果显示,T分期(P=0.013)、组织学分型(P=0.002)、E-Cadherin(P=0.035)是口腔鳞癌患者预后的独立预测因子。结论:p53、E-Cadherin、Ki-67蛋白的表达水平对OSCC患者的预后有一定的作用及临床意义,E-Cadherin是影响患者预后的重要指标。

Objective:To investigate the correlation between expression of p53,Bcl-2,E-Cadherin and Ki-67 proteins in oral squamous cell carcinoma and their significance to prognosis.Methods:A total of 116 patients with oral squamous cell carcinoma were selected in our hospital.The expression of p53,Bcl-2,E-Cadherin and Ki-67 proteins were detected by immunohistochemistry.The correlation of protein expression and clinicopathological features was analyzed,and the prognosis of patients was analyzed by Kaplan-Meier and Cox regression.Results:The expression rates of p53,Bcl-2 and E-Cadherin in tumor were 75%(87/116),19.8%(23/116)and 91.4%(106/116),respectively.The positive expression rate of Ki-67 protein less than 50%in tumor was 31.0%(36/116),and the more than 50%was 69.0%(80/116).The expression of p53 was related to the primary sites and nerve invasion(P<0.05),the expression of E-cadherin was related to the primary sites and nerve invasion(P<0.05),the expression of Ki-67 was related to the situation of invasion front and nerve invasion(P<0.05).There was no correlation with other clinicopathological parameters(P>0.05).Kaplan-Meier analysis showed that the 3-year overall survival rate of OSCC patients in p53 and E-cadherin positive group was lower than that in negative group,and the difference was statistically significant(P<0.05).The 3-year overall survival rate of OSCC patients with high Ki-67 expression group was lower than that of the negative group(P<0.05).Cox regression model showed that T stage(P=0.013),tissue type(P=0.002)and E-Cadherin(P=0.035)were independent prognostic factors of oral squamous cell carcinoma.Conclusion:The expression of p53,E-Cadherin and Ki-67 had effect and clinical significance on the prognosis of OSCC patients,and the expression of E-cadherin is an important indicator affecting the prognosis of patients.