高危TP53突变与口腔鳞状细胞癌中淋巴结外侵犯的相关性分析  

Correlation between high-risk TP53 mutation and extracapsular spread in oral squamous cell carcinoma

作　　者：石磊[1] 陶峰[1] 刘瑞敏[1] 刘巧蓉 SHI Lei;TAO Feng;LIU Rui-min;LIU Qiao-rong(Department of Oral and Maxillofacial Surgery,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]甘肃省人民医院口腔颌面外科

出　　处：《上海口腔医学》2019年第6期644-647,共4页Shanghai Journal of Stomatology

摘　　要：目的:探讨高危肿瘤蛋白53(tumor protein p53,TP53)突变与口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)淋巴结外侵犯(extracapsular spread,ECS)的相关性。方法:回顾性分析2013年1月-2016年1月甘肃省人民医院口腔颌面外科收治的88例OSCC患者资料。根据有无淋巴结转移分为无淋巴结转移组(A1)、淋巴结转移不伴ECS组(A2)、淋巴结转移伴ECS组(A3)。比较各组TP53基因外显子(5-8)在原发灶及转移灶的缺失情况;ECS与无病生存率(disease-free survival,DFS)及总生存率(overall survival,OS)的相关性,TP53突变状态与ECS的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果:A1组、A2组及A3组均发现TP53(5)纯合子缺失;A3组(10/30)发现TP53(6)纯合子缺失;A1组、A2组及A3组均未发现TP53(7)纯合子缺失;A2组(7/42)、A3组(10/30)及A3组(10/60)发现TP53(8)纯合子缺失;A1组1年和3年DFS分别为75.00%和70.83%,A2组1年和3年DFS率分别为70.59%和58.82%,A3组1年和3年DFS分别为46.67%和40.00%,A3组1年和3年DFS显著低于其他2组(P<0.05);A1组1年和3年OS分别为83.33%和75.00%,A2组1年和3年OS分别为73.53%和50.00%,A3组1年和3年OS分别为46.67和40.00%,A3组1年和3年OS显著低于其他2组(P<0.05);A3组发生TP53低危型突变(LR)4例(13.33%),TP53高危型突变(HR)12例(40.00%),TP53野生型突变(Wt)4例(13.33%),其他突变10例(33.33%)。其中,HR型突变与其他突变较其他类型发生例数多(P<0.05);吸烟、原发灶范围、野生型/低风险与高风险/其他与ECS存在相关性(P<0.05)。结论:OSCC患者中ECS是DFS与OS的重要标志物,且ECS中以高危突变较为常见,说明TP53高危突变与OSCC中ECS存在一定相关性。PURPOSE:To investigate the correlation between high-risk tumor protein p53(TP53)mutation and extracapsular spread(ECS)in oral squamous cell carcinoma(OSCC).METHODS:The data of 88 OSCC patients admitted to Gansu Provincial People’s Hospital from January 2013 to January 2016 were retrospectively analyzed.The patients were divided into non-lymph node metastasis group(A1),lymph node metastasis without ECS group(A2),lymph node metastasis with ECS group(A3)according to the presence or absence of lymph node metastasis.The deletion of exon 5-8 of TP53 gene in primary and metastatic lesions was detected.The correlation of ECS with disease-free survival(DFS),overall survival(OS)rate and TP53 mutation were determined,and single factor analysis of ECS was performed.The data were analyzed by SPSS 20.0 software package.RESULTS:TP53(5)homozygote deletion was found in all three groups.TP53(6)homozygous deletion was found in group A3(10/30).No homozygous deletion of TP53(7)was found in three groups.Homozygous deletion of TP53(8)was found in group A2(7/42),group A3(10/30)and group A3(10/60).The 1-year and 3-year DFS rates were75.00%and 70.83%in group A1,70.59%and 58.82%in group A2,46.67%and 40.00%in group A3,with significant dif ference(P<0.05).The 1-year and 3-year OS rates were 83.33%and 75.00%in group A1,73.53%and 50.00%in group A2,46.67%and 40.00%in group A3,with significant difference(P<0.05).In group A3,there were 4 cases(13.33%)of low-risk TP53 mutation(LR),12 cases(40.00%)of high-risk TP53 mutation(HR),4 cases(13.33%)of wild-type TP53 mutation(Wt),and 10 cases(33.33%)of other mutations.HR mutation and other mutations occurred more frequently than other types(P<0.05).Smoking,primary lesion size,wild type/low risk and high risk/others were correlated with ECS(P<0.05).CONCLUSIONS:ECS is an important marker of DFS and OS in OSCC patients,and high-risk mutations were common in ECS,indicating a certain correlation between high-risk mutations of TP53 and ECS in OSCC.

关 键 词：TP53 OSCC 淋巴结外侵犯 基因突变 相关性 

分 类 号：R739.8[医药卫生—肿瘤]