喉鳞癌病理学阴性切缘中eIF4E和p53蛋白检测及其意义

The detection and significance of eIF4E and p53 in the pathological negative margin of laryngeal squamous cell carcinoma specimens

目的 通过对常规病理学阴性切缘中eIF4E和 p5 3蛋白表达与否者的预后进行比较 ,期望在病理学基础上发现更多预后较差患者。方法 回顾性分析 6 7例喉鳞癌的临床资料 ,用免疫组化方法检测病理学阴性切缘中eIF4E、p5 3蛋白表达 ,分别比较eIF4E和 p5 3阴阳性组的生存率和复发率。结果 1.切缘 p5 3、eIF4E阳性率分别是 19.4 % (13/ 6 7)和32 .8% (2 2 / 6 7)。2 .切缘eIF4E阳性者的预后比eIF4E阴性者差 ,包括复发率高 (6 3.6 %Vs 2 8.9% ,P =0 .0 0 6 ) ,生存率低 (4 3.31%Vs77.5 2 % ,P =0 .0 0 0 6 )。 3.切缘 p5 3阳性者复发率高 (6 9.2 %Vs 33.3% ,P =0 .0 18) ,生存率低 (2 4 .6 2 %Vs 75 .6 9% ,P =0 .0 0 12 )。结论 在常规病理学阴性的切缘中 ,eIF4E和p5 3蛋白阳性者的生存率低、复发率高。相对于 p5 3蛋白而言 ,eIF4E蛋白更为敏感些。

Objective The aim of this study was to find out more patients with poor prognosis than the traditional pathological examination through the detection of eIF4E and p53 proteins in the pathological negative margin of laryngeal squamous cell carcinoma(SCC) specimens. Methods The clinical data of 67 laryngeal SCC cases with pathological negative margins were analyzed retrospectively. Immunohistochemical staining was used to detect the expression of eIF4E and p53 proteins in the margins. The survival rate and recurrent rate were compared between the cases with positive and negative eIF4E and p53 margins. Results 1. The rates of positive p53 and eIF4E margins were 19.4%(13/67) and 32.8%(22/67) respectively. 2. The prognosis of those with positive p53 margin was worse than negative group, including the lower survival rate (24.62% vs 75.69%, P=0.0012) and the higher recurrent rate(69.2% vs 33.3%, P=0.018). 3. The prognosis of those with positive eIF4E margin was worse than negative group, the survival rate was lower (43.31% vs 77.52%, P=0.0006) and the recurrent rate was higher (63.6% vs 28.9%, P=0.006). Conclusion The prognosis of those with positive eIF4E or p53 margin is worse than the negative groups in laryngeal squamous cell carcinoma cases with pathological negative margins, It seems that the eIF4E is more reliable than the p53.