口腔黏膜鳞癌线性梯度切缘组织p53和c-erbB-2及EGFR表达对切除范围的指导意义  

Expressions of p53,c-erbB-2 and EGFR in linear gradient surgical margins of oral squamous cell carcinoma and their significance

作　　者：徐加杰[1,2] 葛明华[1] 朱欣[3] 谭卓[1] 凌志强[3] 

机构地区：[1]浙江省肿瘤医院头颈外科,浙江杭州310022 [2]浙江大学医学院口腔医学系,浙江杭州310006 [3]浙江省肿瘤研究所,浙江杭州310022

出　　处：《中华肿瘤防治杂志》2009年第23期1848-1851,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：浙江省医药卫生科学研究基金项目(2004B013);浙江省卫生高层次创新人才培养工程项目

摘　　要：目的:检测口腔黏膜鳞癌(OS-CC)原发灶线性梯度外科切缘组织中p53、c-erbB-2和EGFR的表达情况,寻找肿瘤手术安全切缘的分子标志。方法:应用荧光定量RT-PCR对18例首次外科治疗的OSCC患者20组线性梯度标本(肿瘤组织、0、0.5、1.0、1.5以及2.0cm切缘组织)中p53、c-erbB-2和EGFR的mRNA表达水平进行检测,并采用配对t检验进行统计学分析。结果:在p53mRNA表达水平上各组切缘组织与肿瘤组织相比差异有统计学意义,P<0.01;0.5cm切缘组与0cm切缘组相比差异有统计学意义,P<0.01。在c-erbB-2mRNA表达水平肿瘤组织、0、0.5、1.0和1.5cm切缘组分别与2.0cm切缘组相比差异有统计学意义,P<0.05。在EGFRmRNA表达水平各组切缘组织与肿瘤组织相比差异有统计学意义,P<0.01。结论:荧光定量RT-PCR技术在p53、c-erbB-2和EGFR的表达水平上,对于鉴定肿瘤组织与安全切缘组织的差异具有敏感性。联合p53、c-erbB-2和EGFR在梯度组织基因表达差异上分析提示2.0cm的手术切缘已达到安全边界。OBJECTIVE： To investigate the mRNA expressions of p53, c-erbB-2 and EGFR in the linear gradient surgical margins of oral squamous cell carcinoma （OSCC）, and discuss the possibility of the safe surgical margin identification by fluorescent quantitative real-time PCR technique. METHODS： Twenty linear gradient surgical tissue groups in 18 primary OSCC cases were analyzed in the expressions of p53, c- erbB-2 and EGFR by fluorescent quantitative real-time PCR technique, and each group included tumour tissue and five linear gradient surgical margins with extent of 0, 0. 5, 1.0, 1.5 and 2.0 cm to tumour lesion. The results were analyzed by paired t-test. RESULTS： The highly significant expression discrepancy of p53 was detected in 0, 0.5, 1.0, 1.5 and 2.0 cm surgical margins compared with tumour location respectively （P〈0. 01）, also, 0. 5 cm surgical margins compared with 0 em surgical margins （P〈0.01）. Analogously, the highly significant expression discrepancy of EGFR was detected in 0, 0. 5, 1.0, 1.5 and 2.0 cm surgical margins compared with tumour location respectively （P〈0. 01）. For c -erbB-2, there was the significant expression discrepancy in tumour location, 0, 0.5, 1.0 and 1. S cm surgical margins compared with 2.0 cm surgical margins respectively （P〈 0.05）. CONCLUSIONS： From the expression discrepancies between tumour location and 2.0 cm surgical margins in p53, c-erbB-2 and EGFR, the fluorescent quantitative real-time PCR technique is possibilly sensitive to identify where is the really safe marginal area in surgery at the molecular level. Furtermore, 2.0 cm margin from tumoure location seems to be safe in OSCC surgery. The relationships among the other linear gradient margin groups in p53, c-erbB-2 and EGFR respectively are still not sure.

关 键 词：口腔肿瘤 癌 鳞状细胞 手术切缘 PCR 基因表达 

分 类 号：R739.85[医药卫生—肿瘤]