鼻咽癌颅底侵犯的MRI表现及与p53、p16蛋白表达的关系  

Relationship between the protein p53,p16 expression and MRI findings of the skull base involvement in nasopharyngeal carcinoma

作　　者：吴梅[1] 江新青[1] 梁志伟[1] 郭媛[1] 蒋超[1] 吴红珍[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,广东广州510180

出　　处：《中国医学影像技术》2010年第7期1243-1246,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察鼻咽癌(NPC)颅底骨侵犯的MRI特征及其与p53、p16蛋白表达的关系。方法对150例NPC患者和20例鼻咽炎症患者行鼻咽部MR平扫和增强扫描,并采用免疫组化SABC法检测蛋白质p53和p16的表达。结果 MRI发现颅底骨侵犯63例,其中溶骨性破坏29例,成骨改变13例,混合性破坏9例,骨髓浸润10例,沿神经侵犯2例。破坏部位最多见于斜坡(42例)。NPC及鼻咽炎症中p53、p16蛋白表达率差异有统计学意义(P<0.001)。p53蛋白表达与分化程度、颅底骨质侵犯相关(P<0.001),形成溶骨性颅底破坏的NPC组织与仅有颅底骨成骨改变者中p53蛋白表达率分别为93.10%(27/29)、61.54%(8/13),差异有统计学意义(P<0.05)。p16蛋白表达与颅底骨质侵犯无关。结论 p53蛋白表达与NPC颅底侵犯有一定相关性。成骨改变可能是反应性骨改变,颅底骨质破坏形式可以反映p53蛋白的表达情况。Objective To assess the relationship between the expression of protein p53,p16 and MRI features of bone involvement of the skull base in nasopharyngeal carcinoma （NPC）. Methods Totally 150 patients of NPC and 20 patients of nasopharyngitis underwent MR plain and enhanced scan. All the patients were examined for expression of protein p53 and p16 with SABC immunohistochemical method. Results MR showed skull base invasion was detected in 63 patients,including osteolytic lesions in 29,sclerotic lesions in 13 and mixed lesions in 9. The early bone marrow infiltration was seen in 10 patients. MRI revealed nasopharyngeal carcinoma tissue infiltrated along the mandibular nerve in 2 patients. The clivus was most often involved. The positive expression of p53,p16 in NPC and nasopharyngeal inflammation had significant difference （P〈0.001）. Protein p53 expression was correlated with histodifferentiation and skull base destruction （P〈0.001）. The positive expression of p53 in NPC with osteolytic skull base involvement and NPC with sclerotic lesions was 93.10% （27/29） and 61.54% （8/13,P〈0.05）. No significant difference was found in skull base destruction with p16 protein expression. Conclusion Protein p53 expression is correlated with skull base destruction. The sclerotic lesions may be reactive changes. The types of skull base destruction can reflex the expression status of p53 protein.

关 键 词：鼻咽癌 颅底 磁共振成像 基因 p53 基因 p16 

分 类 号：R739.63[医药卫生—肿瘤] R445.2[医药卫生—临床医学]