牙龈鳞癌中PTEN基因启动子甲基化状态及预后分析

目的 探讨牙龈鳞癌中PTEN基因启动子甲基化状态及其预后的价值.方法 以唐山市协和医院2005年9月至2010年9月收治的牙龈癌患者石蜡标本30例为研究对象,从中随机抽取高、中、低分化各10例(共30例),用甲基化特异性PCR法检测其PTEN基因启动子区甲基化的状态,统计这些病例PTEN启动子区的甲基化状况,结合牙龈癌患者病历资料和随访信息,采用Kaplan-Meier方法 绘制生存曲线,分析PTEN甲基化状态与牙龈癌预后的相关性.结果 30例牙龈鳞癌中PTEN启动子甲基化率为36.7％,且N分期甲基化率高于T分期;PTEN启动子甲基化情况与牙龈鳞癌患者的N分期、细胞分化程度有显著相关性(P<0.05);PTEN基因启动子甲基化患者的中位生存时间85个月,无甲基化患者的中位生存时间108个月,两者比较差异有统计学意义(P<0.05).结论 PTEN启动子甲基化与N分期和细胞分化程度相关,可能是影响牙龈鳞癌患者预后的独立危险因素,对评价患者预后具有重要临床实际意义.PTEN启动子甲基化在口腔鳞癌的发生、发展及预后起着重要作用,可作为判断预后的参考指标之一.

Methylation status of PTEN gene promoter in gingival squamous cell carcinoma and its prognostic value

Objective To investigate the prognosis of methylation status of PTEN gene promoter in gingival squamous cell carcinoma and its prognostic value.Methods Thirty paraffine-embeded specimens from 30 patients with gingival squamous cell carcinoma who were admitted and treated in Xiehe Hospital of Tangshan City were enrolled in the study.The 30 specimens were randomly divided into three groups: high differentiation group (n=10),moderate differentiation group (n=10) and low differentiation group (n=10).The methylation status of PTEN gene promoter was detected by methylation specific PCR method for the three groups.Then to use Kaplan-Meier method combining with patient's case history and follow-up data to draw survival curve,and to analyze the correlation between methylation status of PTEN gene promoter and patient's prognosis.Results The methylation rate of PTEN promoter in 30 cases of gingival squamous cell carcinomas was 36.7％,moreover, the methylation rate at stage N was higher than that at stage T.The PTEN promoter methylation status was closely correlated to stage N of gingival squamous cell carcinoma and cell differentiation degree (P<0.05).The median survival time in patients with PTEN gene promoter methylation was 85 months,however,which in patients without methylation was 108 months,there was a significant difference between them.Conclusion The PTEN promoter methylation is closely correlated to stage N of gingival squamous cell carcinoma and cell differentiation degree,which may be an independent risk factor influencing patient's prognosis and may have important clinical significance in evaluating prognosis of patients.PTEN promoter methylation may play an important role in pathogenesis, development and prognosis of oral squamous cell carcinoma,therefor,which can be regarded as one of indexes to evaluate patient's prognosis.