鼻咽癌颅底侵犯MRI表现与p53蛋白的关系  

The Relationship between the p53 Protein Expression and MRI Findings of the Skull Base Involvement in Nasopharyngeal Carcinoma

作　　者：吴梅[1] 江新青[1] 陈亮[1] 魏新华[1] 夏建东[1] 梁志伟[1] 

机构地区：[1]广州医学院附属广州市第一人民医院放射科,510180

出　　处：《临床放射学杂志》2010年第6期750-753,共4页Journal of Clinical Radiology

摘　　要：目的研究鼻咽癌颅底骨侵犯MRI表现与p53蛋白表达的关系。资料与方法经病理证实的鼻咽癌150例(其中颅底骨侵犯者63例),均行鼻咽部MRI平扫加增强扫描。采用Philips1.5T超导磁共振仪,头部Sense线圈。应用免疫组织化学SABC法检测所有病例中的p53蛋白表达。结果颅底骨侵犯中单一部位者16例(25.4%),47例为多处颅底骨侵犯。破坏部位最多见于斜坡,溶骨性破坏最多见(47例)。骨质硬化型4例(6.3%),骨髓浸润型10例(15.9%),沿神经侵犯2例(3.2%)。鼻咽癌及鼻咽黏膜慢性炎症中p53蛋白表达率的差异有极显著意义(P<0.001)。p53蛋白表达与分化程度、颅底骨质破坏相关(P<0.001),与临床分期、颈部淋巴结转移无关。结论 MRI可作为评价鼻咽癌颅底骨侵犯首选检查方法 ,尤其在评价鼻咽癌早期骨髓侵犯方面MRI比CT敏感。p53在鼻咽癌发生、发展中起重要作用,p53蛋白表达与鼻咽癌分化程度、颅底侵犯有一定相关性。Objective To study the relationship between the expression of p53 protein and MRI features of bone involvement of the skull base in nasopharyngeal carcinoma.Materials and Methods There were 150 patients（skull base involvement 63 cases）of nasopharyngeal carcinoma,all of them were confirmed by biopsy.The MR images were obtained on 1.5T unit.The head sense coil was used.MRI plain scan and enhanced scan were used.And all cases were examined for expression of p53 protein by SABC immunohistochemical method.Results There were 16 cases with single site involved and 47 cases with multi-sites involved.The clivus destruction were most common.Osteolytic lesions were most common（47 cases）,osteosclerosis 4 cases（6.3%）,marrow erosion 10 cases（15.9%）,spreading along the nerve 2 cases（3.2%）.The positive expression for p53 in nasopharyngeal carcinoma and chronic nasopharyngeal mucosa inflammation had significant difference（P〈0.001）.p53 protein expression was correlated with histodifferentiation and skull base involvement（P〈0.001）,and had no correlation with clinical stages and cervical lymph nodes metastasis.Conclusion MR imaging is a preferred method in evaluating nasopharyngeal carcinoma invasion skull base.MR imaging is more sensitive than CT especially in detecting NPC invasion marrow.p53 might play an important role in the pathogenesis and development of nasopharyngeal carcinoma.p53 protein expression was correlated with histodifferentiation and skull base destruction.

关 键 词：鼻咽癌 颅底骨 磁共振成像 蛋白质P53 免疫组织化学 

分 类 号：R739.63[医药卫生—肿瘤]