喉基底样鳞状细胞癌中人乳头状瘤病毒及细胞周期相关蛋白的表达  

Significance of HPV and cell cycle related proteins in basaloid squamous cell carcinoma of the larynx

作　　者：崔力方[1,2] 昌红[1] 赵洪禹 曲丛玲[1] 高颖[1] 刘红刚[2] Cui Lifang;Chang Hong;Zhao Hongyu;Qu Congling;Gao Ying;Liu Honggang(Department of Pathology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院病理科,100038 [2]首都医科大学附属北京同仁医院病理科、头颈部分子病理诊断北京市重点实验室,100038

出　　处：《中华病理学杂志》2018年第9期682-686,共5页Chinese Journal of Pathology

基　　金：头颈部分子病理诊断北京市重点实验室开放研究课题（2016TJBF03）;首都卫生发展科研专项（2014-2-2053）

摘　　要：目的研究喉基底样鳞状细胞癌（basaloid squamous cell carcinoma，BSCC）中人乳头状瘤病毒（HPV）及细胞周期相关蛋白的表达及意义。方法收集北京同仁医院2005年1月至2011年12月332例喉鳞状细胞癌（scc）病理资料，包括303例普通型SCC及29例喉BSCC，回顾性分析其中29例喉BSCC（8．7％）临床病理学特点，采用聚合酶链反应（PCR）反向点杂交方法检测HPVDNA，免疫组织化学sP法染色观察细胞周期相关蛋白p53、Ki．67、p16、p21、cyclinD1的表达，比较分析以上指标与肿瘤大小、分期、部位、淋巴结转移等主要病理学特点的关系，初步探讨HPV与细胞周期相关蛋白之间的相关性。结果（1）29例喉BSCC男性27例，女性2例，年龄46-82岁（中位年龄62岁），与普通型SCC相比，发病年龄、淋巴结转移个数、淋巴结转移率及声门上肿瘤的发生率略高，但差异无统计学意义（P〉0．05）。（2）喉BSCC中27．6％（8／29）检测到HPVDNA，且均为HPV16，HPV的表达与年龄、是否饮酒及分期、肿瘤大小等无关（P〉0．05）。（3）31．0％（9／29）的喉BSCC表达p53，且p53阳性病例更容易发生于声门上并伴有淋巴结转移（P〈0．05）。p16的阳性表达率为24．1％（7／29），其淋巴结转移率略高于p16阴性病例，p21、cyclinD1的表达率分别为27．6％（8／29）和69．0％（20／29），与年龄、肿瘤大小、分期、淋巴结转移、是否吸烟、饮酒等均无相关性（P〉0．05）。（4）8例HPV阳性的BSCC只有3例p16阳性，HPV阳性组p21及Ki-67阳性指数比HPV阴性组增高（P〈0．05）。结论部分喉BSCC表达HPV，个别病例可能为HPV相关性喉BSCC，p16表达并不是喉BSCCHPV感染的可靠替代性指标。Objective To study the significance of HPV and cell cycle related proteins in basaloid squamous cell carcinoma （ BSCC ） of the larynx. Methods Twenty-nine cases of laryngeal BSCC from Beijing Tongren Hospital from January 2005 to December 2011 were reviewed. HPV typing by polymerase chain reaction-reverse dot blot （PCR-RDB） and p53, Ki-67, p16, p21 and eyelin D1 expression by immunohistoehemistry were performed. The relationship between these indicators, various pathologic parameters （TNM, tumor size, tumor site and lymph node metastasis ） and HPV status was analyzed. Results There were 27 male and 2 female patients. The median age was 62 years. Lymph node metastasis and supraglottie tumor location were slightly higher than that of ＂usual＂ SCC, but not statistically significant （P〉O. 05）. HPV DNA was detected in 27. 6% （8/29） of the laryngeal BSCC, and all were HPV16. The expression of HPV was not related to age, alcohol consumption, tumor stage and tumor size. p53 was expressed in 31.0% （9/29） of laryngeal BSCC, and these cases were more likely supraglottic and had lymph node metastases （P〈0. 05）. p16 staining was seen in 24. 1% （7/29） of laryngeal BSCC, and these cases showed slightly higher rate of lymph node metastasis compared to p16 negative cases. The expression rates of p21 and cyelinD1 were 27.6% （8/29） and 69. 0% （20/29） , respectively, which were not related to age, tumor size, stage, lymph node metastasis, smoking and drinking. There were only 3 pl6＋/HPV＋ cases, which showed higher p21 and Ki-67 index compared to the HPV negative group （P〈0. 05）. Conclusion Some laryngeal BSCC expresses HPV DNA, possibly indicating an association with HPV; but p16 expression is not a reliable indicator for HPV infection.

关 键 词：喉肿瘤 癌 鳞状细胞 DNA探针 HPV 基因 P16 

分 类 号：R739.65[医药卫生—肿瘤]