头颈鳞癌切缘突变型p53表达与肿瘤局部复发和预后的关系  

The Relationship between P53 Protein Expression, Prognosis and Local Tumor Recurrence in the Surgical Margins of Patients with Head and Neck Squamous Cell Carcinoma

作　　者：李超[1] 陈锦[1] 王朝晖[1] 陈建超[1] 张兵[1] 李彬[1] 王少新[1] 江庆华[1] 宋宇峰[2] 

机构地区：[1]四川省肿瘤医院研究所头颈外科,成都市610041 [2]贵阳医学院附属医院口腔颌面外科

出　　处：《中国肿瘤临床》2009年第14期816-819,共4页Chinese Journal of Clinical Oncology

基　　金：四川省卫生厅科研基金资助(编号:070030)

摘　　要：目的:探讨头颈鳞癌手术切缘p53表达及其与肿瘤局部复发和预后的关系。方法:用免疫组织化学的方法检测82例头颈鳞癌患者手术切缘中p53的表达情况,并分析其与肿瘤局部复发,临床病理学参数和预后之间的关系。结果:在82例头颈鳞癌患者中,切缘塞变型p53阳性表达率为59.76%(49/82)。阳性表达主要定位于切缘上皮细胞核。p53蛋白在头颈鳞癌手术切缘中的表达显著高于其在正常口腔粘膜组织中的表达(x2=10.497,P<0.05)。头颈鳞癌患者手术切缘p53的表达与肿瘤分化程度(x2:12.332,P<0.01)和局部复发显著相关(x2=5.425,P<0.05),但与患者年龄、性别、肿瘤病理分期以及淋巴结转移无关(P>0.05)。切缘p53表达阴性组较阳性组术后可能有较好的预后(x2=3.559,P=0.059)。结论:切缘p53的阳性表达与头颈鳞癌术后肿瘤的进展有关,它有望成为指导头颈鳞癌治疗和判断预后的一项重要指标。Objective： To investigate the expression of P53 protein in the surgical margins of patients with head and neck squamous cell carcinoma （HNSCC）, and to analyze its relationship with local tumor recurrence and prognosis. Methods： The expression of P53 protein in 82 cases with HNSCC was detected by immunohistochemistry. The correlations among P53 protein, local recurrence, clinicopathologic parameters and prognosis in these cases were investigated. Results： Of the 82 cases with HNSCC, 59.76% （49/82） cases had positive expression of P53 protein in the surgical margins. P53 protein was mainly detected in the nucleus of epithelial cells in the surgical margins. The expression of P53 protein was significantly higher in the surgical margins of patients with HNSCC than in normal oral mucosa （χ^2=10.497, P〈0.05）. Positive expression of P53 protein was significantly correlated with tumor differentiation （χ^2=12.332, P〈0.01） and local recurrence （χ^2= 5.425, P〈0.05）. No correlations were found among P53 expression and age, gender, pathological stage, or lymph node metastasis （P〉0.05）. The prognosis may be better in patients with positive p53 protein than in patients without P53 expression （χ^2=3.559, P=0.059）. Conclusion： The expression of P53 protein in surgical margins is correlated with the development of HNSCC after surgery. P53 protein expression may serve as a prognostic factor and can help make informed judgments about which patients will benefit from treatment.

关 键 词：头颈鳞状细胞癌 p53 切缘组织 局部复发 预后 

分 类 号：R739.91[医药卫生—肿瘤]