喉癌手术切缘组织中p53、p21、PCNA及COX-2蛋白的表达与肿瘤局部复发的关系  

Expression of p53,p21,PCNA and COX-2 and its relationship with recurrence in the early-stage laryngeal cancer with negative surgical margin

作　　者：曾荣华 

机构地区：[1]武汉市第三医院耳鼻咽喉科,武汉430000

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第5期349-352,356,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的：探讨喉癌手术切缘组织中p53、p21、PCNA及COX-2蛋白的表达与肿瘤局部复发的关系。方法：选取2005-11-2010—12期间住院的98例喉癌患者，病理检查均为早期喉鳞状细胞癌，所有患者均实施CO：激光手术方式切除，切除整块肿瘤后，留取肿瘤原发灶组织和手术切缘组织，保留5mm癌周组织作为手术切缘标本。采用SP法进行免疫组织化学检测，每3～6个月门诊或电话随访，对局部组织复发情况进行详细记录，随访3．0～4．5年。结果：①98例喉癌患者的肿瘤组织中p53、p21、PCNA及COX-2蛋白的阳性率为65．3％、52．00．4、70．4014及69．4％；手术切缘组织中p53、p21、PCNA及COX-2蛋白的阳性率为23．5％、39．8％、32．7％及30．6％；差异有统计学意义（均P〈0．05）；p53、p21、PCNA及COX-2蛋白在喉癌组织中的表达与肿瘤的分级及TNM分期无关。②98例患者随访3年以上，局部复发17例（17．3％）。切缘组织中p53、p21、PCNA及COX-2阳性表达的患者复发率高于阴性表达的患者（P〈0．05），其中p53和p21、PCNA和COX-2检测共阳性的患者复发率显著高于单阳性的患者（P〈0．05）。③p21在p53阳性切缘组织中的阳性表达显著高于其在阴性切缘组织中的表达；PCNA在p21、COX-2阳性切缘组织中的阳性表达显著高于其在阴性切缘组织中的表达（P〈0．01）；但PCNA在p53阳性切缘组织中的阳性表达与其在阴性切缘组织中的表达差异无统计学意义（P〉0．05）。结论：通过探讨p53、p21、PCNA及COX-2在喉癌细胞增生及局部复发过程中的作用，提示生化代谢与分子结构水平表达异常先于细胞形态表观的改变，建议对阳性指标进行随访检测，阳性表达的患者可采取相应的措施对症干预。Objective：To explore the relation between the expression of p53,p21,PCNA and COX-2and local recurrence in resection margins of laryngeal carcinoma operation.Method：SElect 98 patients with laryngeal carcinoma,who came to our hospital from Nov,2005 to Dec,2010.Diagnosed with early laryngeal squamous cell carcinoma by apathological examination,all these patients received CO2 laser surgery to cut the entire tumors.Keep the primary lesion and resection margin tissues after that and take 5mm peritumoral tissue as a sample of operation resection margin.With the chemical method of SP,record in detail the local recurrence condition by clinical diagnosis every 3-6months or telephone follow-up for 2years.Result：1The positive rate of p53,p21,PCNA and COX-2in the tumor tissues of the 98 patients with laryngeal carcinoma are 65.3%,52.0%,70.4% and 69.4%.The positive rate of p53,p21,PCNA and COX-2in their resection margin tissues are 23.5%,39.8%,32.7%and 30.6%.So there is no relation between the expression of p53,p21,PCNA and COX-2in tumor tissue and tumorous grading and TNM staging.2There appeared 17 cases of local recurrence in two years,with a recurrence rate of 17.3%.The recurrence rate of patients with a positive expression of p53,p21,PCNA and COX-2in resection margin tissue is higher than those with a negative expression（P〈0.05）.Among positive cases,the recurrence rate of patients with double positive results is obviously higher than those with single positive results（P〈0.05）.3The expression of p21 in p53positive resection margin tissue is greatly higher than that in negative tissue.The expression of PCNA in p53 positive resection margin tissue is greatly higher than that in negative tissue（P〈0.01）;however,the PCNA positive expression in p53 positive cut edge organization rather than in the expression of negative cut edge groups（P〉0.05）.Conclusion：Through the discussion on the effect of p53,p21,PCNA and COX-2in the process of laryngeal carcinoma cell proliferation and local recurrence,the st

关 键 词：喉癌 P53 P21 PCNA COX-2 局部复发 

分 类 号：R739.65[医药卫生—肿瘤]