肝细胞癌8号染色体微卫星变异及其与临床病理特征的关系

目的　探讨肝细胞癌 (HCC)微卫星变异的特点及其与临床病理表现的相关性。方法采用毛细管电泳DNA分析系统 ,对 5 6例HCC中 8号染色体上 10个微卫星的杂合子丢失 (LOH)、微卫星不稳定性 (MSI)和等位基因失衡 (AI) 3种变异特征进行检测。结果　 5 6例HCC在 8号染色体上 10个基因位点发生LOH的总频率为 6 6 1% (37/ 5 6 ) ,LOH以D8S2 6 1最高为 5 3 5 % (2 3/ 4 3) ,其次为D8S172 1(5 2 5 % )和D8S1771(5 2 5 % )。D8S2 77基因位点 ,血清HBsAg阳性患者的LOH频率显著高于HBsAg阴性者 (P <0 0 1) ,D8S2 6 1、D8S2 98和D8S1733基因位点 ,血清HBsAg阴性患者的LOH频率显著高于HBsAg阳性者 (P <0 0 1) ;D8S2 98和D8S1771基因位点 ,直径 >3cm肿瘤的LOH率明显高于≤ 3cm组 (P <0 0 5和P <0 0 1) ;在D8S172 1基因位点 ,无包膜或包膜不完整的肿瘤的LOH显著高于包膜完整的肿瘤 (P <0 0 1) ;D8S2 98和D8S1771基因位点 ,肝内转移者的LOH明显高于无肝内转移者 (P <0 0 5 )。MSI的频率为 12 5 % (7/ 5 6 ) ,AI的频率为 19 6 % (11/ 5 6 )。结论HCC在 8号染色体上存在广泛的微卫星变异 ,其中LOH方式在HCC的发生和发展过程中起重要作用 ,MSI的作用次之。特定基因位点的LOH与临床和病理学参数有一定的相关性     

头颈部鳞癌的微卫星不稳定性和杂合性丢失的初步研究

目的:探讨头颈部鳞癌的微卫星不稳定性(MSI)及杂合性丢失(LOH)。方法:选择来自3、5、6、8、9、13、17和18号染色体的15个微卫星标志对36例头颈部鳞癌标本和相应的外周血进行微卫星分析。结果:36例头颈部鳞癌中,27.8%(10/36)分别有1-8个位点存在MSI,MSI发生率较高的位点为:D17S520(22.9%)、D6S105(16.7%)和D8S264(13.9%)。在9p21-p22和3p14等处存在一定的LOH。微卫星异常的检出率与肿瘤分期、分级无相关性。结论:提示MSI是头颈部鳞癌中较为常见的遗传学变化,染色体9p21-p22和3p14区域可能存在与头颈部鳞癌有关的抑癌基因。     

喉癌中转谷氨酰胺酶3基因杂合性丢失和表达研究

目的 探讨转谷氨酰胺酶3（transglutaminase 3,TGM3)基因在喉癌发生中的作用。方法 在TGM3基因内部及附近选择微卫星标记进行杂合性丢失（loss of heterozygosity,LOH)分析，于DNA水平间接检测72例喉癌患者中该基因的缺失；并进一步应用Northern杂交检测8例喉癌患者配对肿瘤及癌旁正常组织中TGM3基因的表达差异。结果 4个短串联重复序列（short tandem repeats,STR)位点均存在LOH，其中D20S17、D20S607、D20S99和D20S841位点的LOH频率分别为25.76%、20.00%、38.10%和18.75%，至少1个位点出现LOH的病例占61.11%，杂合性丢失与临床分期、淋巴结转移和分化程度无显著相关性；Northern杂交结果显示8例喉癌患者TGM3基因在正常组织中的表达比肿瘤组织显著增强。结论 TGM3基因在喉癌的发生中具有重要作用，具体机理有待进一步研究。     

卵巢癌PTEN基因失活机制的探讨

目的　旨在从DNA、mRNA及蛋白水平,探讨卵巢癌PTEN基因的失活机制。方法　48例卵巢癌标本,应用位于染色体10q23 3的4个多态性标记(D10s541、D10s583、D10s1687和D10s2491),采用聚合酶链反应(PCR)及杂合性缺失分析法,检测了PTEN杂合性缺失(LOH);采用聚合酶链反应单链构象多态性分析法(PCR SSCP)检测了PTEN第5、第6、第7和第8外显子的突变;采用逆转录(RT) PCR及免疫组织化学技术检测了PTENmRNA及蛋白的表达。结果　39 6%(19 /48)的卵巢癌存在PTEN基因的LOH, PTEN突变率仅为4 2% (2 /48),PTENmRNA表达缺失率为18 8% (9 /48),蛋白表达缺失率达27 1% (13 /48)。PTEN蛋白表达缺失的病例,LOH的发生率69 2% (9 /13)高于表达阳性者的28 6% (10 /35),差异有统计学意义(P<0 05 )。13例PTEN蛋白表达缺失的病例中,仅有2例( 15 4% )同时有突变和LOH,即存在双等位基因的结构异常; 7例(53 8% )有LOH,其中5例PTENmRNA表达缺失,另2例表达正常; 4例( 30 8% )既无突变也无LOH,其中2例PTENmRNA表达缺失,另2例表达正常。结论　PTEN基因失活在卵巢癌的发病中可能起一定的作用,其失活可能存在多种机制,蛋白表达缺失可能是重要的失活机制。     

神经鞘瘤D22S268杂合缺失与组织学类型的相关性研究

目的　探讨神经鞘瘤组织学类型与NF2基因微卫星标记D2 2S2 6 8杂合性缺失 (LOH)的相关性。方法　选择与NF2基因密切相关的微卫星标记D2 2S2 6 8,应用PCR方法检测 35例神经鞘瘤患者的新鲜肿瘤组织标本。结果　病理分型为AntoniA型 2 0例 ,其中LOH 15例 ;AntoniB型 15例 ,LOH 0例。两种病理分型中D2 2S2 6 8LOH发生率存在着显著差异 (P <0 .0 1)。结论　NF2基因的LOH可能在AntoniA型的神经鞘瘤发生过程中起决定性作用。     

口腔鳞癌及癌前病变组织中p27、p53蛋白的表达

目的　探讨 p2 7、p5 3蛋白表达在口腔鳞癌发生发展中的意义。 方法　应用免疫组化S P法分别检测 9例口腔正常黏膜 ,11例单纯性增生、2 6例癌前病变及 5 4例鳞癌组织中p2 7、p5 3蛋白的表达。 结果　p2 7蛋白在口腔正常黏膜和单纯性增生组织中呈高表达 ,在癌前病变和鳞癌组织中高 (低 )表达率分别为 6 1 5 % (38 5 % )、2 5 9% (6 1 1% ) ,在鳞癌中阴性表达率为 13% ;p2 7蛋白的表达与鳞癌的组织分化程度、临床分期相关 (P <0 0 5 )。p5 3蛋白在正常黏膜、单纯性增生及轻、中度不典型增生中未见表达 ,在重度不典型增生和鳞癌中可见 2 8 6 %和 4 8 1%的阳性表达 ,二者差异有高度显著性 (P <0 0 1) ;在鳞癌中 p5 3蛋白表达与组织分化程度相关 (P <0 0 5 ) ;p2 7和p5 3表达在鳞癌中呈负相关 (P <0 0 1)。 结论　p2 7蛋白表达的减少在口腔鳞癌的发生发展中起着重要作用 ,并与其预后因素密切相关。p5 3蛋白的表达在癌前病变向鳞癌转变过程中起重要作用。综合分析 p2 7、p5 3表达有助于口腔鳞癌的早期诊断和患者预后的估计。     

上皮性卵巢癌组织脆性组氨酸三联基因甲基化和3p14的等位基因丢失

目的 探讨肿瘤抑制基因脆性组氨酸三联(FHIT)基因在上皮性卵巢癌(简称卵巢癌)组织中的甲基化状态以及该基因定位的3p14位点的等位基因丢失及其在卵巢癌的发生发展中的作用。方法采用甲基化特异性聚合酶链反应(MSP)方法检测61例卵巢癌组织及10例交界性上皮性卵巢肿瘤(简称交界性卵巢肿瘤)组织FHIT基因启动子CpG岛的甲基化频率,并采用微卫星多态性标志D3S1287检测45例卵巢癌组织3p14位点杂合子丢失(LOH)和纯合子丢失(HD)状态。结果卵巢癌组织中FHIT基因甲基化频率为39．3％(24／61),其中浆液性囊腺癌为45．2％(19／42),黏液性囊腺癌为14．3％(1／7),子宫内膜样癌为33．3％(4／12);交界性卵巢肿瘤组织中FHIT基因甲基化为6／10,其中交界性浆液性囊腺瘤1／3,交界性黏液性囊腺瘤5／7。卵巢癌组织甲基化频率与临床分期、细胞分化程度相关性无统计学意义。交界性卵巢肿瘤与卵巢癌之甲基化频率差异无统计学意义。43．5％(10／23)卵巢癌显示LOH;有信息的浆液性囊腺癌中33．3％(6／18)检测到HD。FHIT基因甲基化与基因丢失之间无明显相关性。结论首次证实卵巢癌FHIT基因启动子有较高的甲基化频率,这可能是FHIT基因沉默的重要原因,在卵巢癌的发生与发展过程中起着重要的作用;同时3p14位点等位基因的丢失可使基因完全失去功能,促进肿瘤的发生。     

子宫颈癌组织中RACK1和β-catenin的表达及临床意义

目的探讨RACK1和β-catenin在子宫颈癌组织中的表达及临床意义。方法采用RT-PCR技术检测126例子宫颈癌组织及癌旁正常子宫颈组织中RACK1 mRNA和β-catenin mRNA的表达;采用免疫组化SP法检测RACK1和β-catenin的表达,分析两者与子宫颈癌临床病理特征及预后的相关性。结果子宫颈癌组织中RACK1 mRNA相对表达量低于癌旁正常子宫颈组织,而β-catenin mRNA相对表达量高于癌旁正常子宫颈组织,两组相比差异有统计学意义(P 0. 05)。子宫颈癌组织中RACK1阳性率(19. 0%)低于癌旁正常子宫颈组织(63. 5%),而β-catenin在子宫颈癌中的阳性率(69. 0%)高于癌旁正常子宫颈组织(31. 0%),差异有统计学意义(P 0. 05)。TNM分期越高、分化程度越低、合并淋巴结转移的子宫颈癌中RACK1阳性率越低,而β-catenin阳性率越高(P 0. 05)。RACK1和β-catenin蛋白表达呈负相关(r=0. 404,P 0. 05)。RACK1蛋白强阳性者和β-catenin蛋白弱阳性者生存率较高(42. 8%vs 33. 3%,42. 8%vs 36. 4%),但差异无统计学意义(P 0. 05),两组中位生存时间相比,差异有统计学意义(57. 2 vs 34. 0,44. 2 vs 29. 8,P 0. 05)。RACK1弱阳性和β-catenin强阳性是子宫颈癌患者不良预后的影响因素(HR分别为9. 654和8. 882,P均0. 05)。结论 RACK1和β-catenin蛋白异常表达可能与子宫颈癌的发生、发展和预后有关,并影响子宫颈癌的淋巴结转移。     

中国人肝癌分泌型卷曲相关蛋白1基因遗传的不稳定性

目的 研究8号染色体上D8S532位点的杂合性缺失(LOH)和微卫星不稳定性(MSI)对分泌型卷曲相关蛋白1基因(sFRP1)蛋白表达的影响,阐明 sFRP1 基因遗传不稳定性与肝癌进展的关系,为揭示sFRP1 基因作用机制和肿瘤发生发展机制提供实验依据. 方法 采用石蜡包埋组织抽提DNA,聚合酶链-单链构象多态性(PCR-SSCP)分析,常规银染检测D8S532位点的LOH和MSI,采用Envision免疫组织化学染色,Leica-Qwin计算机图像分析系统采图和Image-Pro P1uS(IPP)Version5.0专业图像分析软件分析蛋白表达. 结果 在36例肝癌中,D8S532位点LOH和MSI检出率分别为11.11%(4/36)和8.33%(3/36),D8S532位点MSI发生率在60岁以上年龄组(≥60) 26.67%(4/15),高于60岁以下年龄组(<60)0.00%(0/21, P <0.05).相比较于正常组织,86.11%(31/36)的sFRP1蛋白有不同程度表达下降,在肝癌组织中,sFRP1表达阳性率为52.78%(19/36),蛋白表达阴性组LOH阳性率为23.53%(4/17),明显高于蛋白阳性组的0.00%(0/19)( P <0.05). 结论 在中国人肝癌发生进展中,sFRP1蛋白表达下降甚至缺失是普遍现象, sFRP1 基因的遗传不稳定性可能是导致该抑癌基因突变、肿瘤发生的一个机制,LOH在sFRP1表达缺失的过程中起了重要作用.     

肺鳞状细胞癌的M6P/IGF2R突变

为了探测肺鳞状细胞癌的甘露糖 - 6-磷酸酶 /类胰岛素生长因子 ( M6P/IGF2 R)有否突变 ,作者通过组织显微镜解剖法收集样本 ,PCR扩增DNA,M6P/IGF2 R测序及免疫组化染色 ,对 2 2例新诊断尚未治疗的肺鳞状细胞癌样本进行了杂合性丢失 ( LOH)筛查。结果表明 ,肺鳞状细胞癌中常见 M6P/IGF2 R突变 ,其正常功能为肺癌抑制基因。 1 9/2 2例( 86% )有 LOH信息 ,其杂合信息为该受体 3′-非翻译区的多聚二核苷酸重复序列和四核苷酸插入或缺失性多态。在 1 1 /1 9例 ( 5 8% ) M6P/IGF2 R基因座有 LOH信息的患者中 6女 1 3男 ,平均年龄 …     

Association of allelic loss at the FHIT locus and p53 alterations with tumour kinetics and chromosomal instability in non-small cell lung carcinomas (NSCLCs)

The FHIT gene, located at the FRA3B fragile site of chromosome 3p14.2, encodes a 16.8 kD homologue of the yeast enzyme diadenosine tetraphosphate (Ap(4)A) hydrolase. Frequent allelic losses at this region in various malignancies, including non-small cell lung carcinomas (NSCLCs), imply that FHIT may represent a tumour suppressor gene (TSG). Increasing evidence suggests that multiple TSG impairment has a synergistic effect on tumour growth. The present study of 67 NSCLCs investigated the allelic imbalance (AIm) within the FHIT locus and its relationship with p53 abnormalities, kinetic parameters [proliferative activity or proliferation index (PI) and apoptotic index (AI)], and ploidy status of the carcinomas. Allelic imbalance at FHIT was observed in 35 out of 55 informative (heterozygous: H) cases (64%). Similar frequencies of loss of heterozygosity (LOH) were noticed among squamous cell lung carcinomas and adenocarcinomas. The high percentage of AIm in stage I tumours (71%) is indicative of its relatively early involvement in NSCL carcinogenesis. No association was found between LOH at FHIT, kinetic parameters, and ploidy status of the tumours. Concurrent loss at FHIT and p53 overexpression [FHIT(LOH)/p53(P)] was the most frequent pattern and was observed in 39% of the informative cases. The latter pattern was not associated with smoking, supporting the hypothesis that in patients with a history of tobacco exposure, FHIT allelic loss may not be a consequence of p53 checkpoint defects, but the outcome of tobacco-induced mutagenesis. Statistically significant differences in the presence of FHIT(LOH)/p53(P) and FHIT(LOH)/p53(N) patterns were noted at the proliferative and apoptotic level, whereas ploidy was similar amongst all groups, implying that wild-type (wt) p53 may play a safeguard role against altered FHIT function. However, the possibility of a masking effect from wt p53 cannot be excluded, since the FHIT(LOH)/p53(P) profile demonstrated a higher growth index (GI=PI/AI mean value ratio) than FHIT(H)/p53(P) (32 vs. 8), although this was not significant. Further studies are needed in order to elucidate the role of FHIT and its relationships with other cell-cycle regulatory molecules involved in NSCL carcinogenesis.     

FHIT在喉癌中的研究进展

［摘要］ 脆性组氨酸三联体基因（fragile histidine triad， FHIT）是位于3p14.2上的抑癌基因，它可以通过水解Ap3A、改变线粒体跨膜电位及增强微管蛋白聚合来诱导细胞凋亡。FHIT的改变包括纯合性缺失、微卫星不稳定(MSI)、杂合性缺失（LOH）及启动子甲基化在喉鳞状细胞癌中有非常重要的作用。FHIT基因可能成为喉鳞状细胞癌的基因治疗靶点     

Loss of heterozygosity at 11q23.3 in vasculoinvasive and metastatic squamous cell carcinoma of the cervix

We have previously demonstrated a strong relationship between loss of heterozygosity (LOH) at chromosome 11q23.3 and the presence of extensive tumor plugs in lymphvascular spaces (LVS) in stage 1B cervical carcinoma, suggesting that genes at this locus may regulate vasculoinvasion. This study examined LOH at 11q23.3 in microdissected tumor plugs within LVS and in metastatic foci in lymph nodes (MFLN), as well as corresponding invasive tumor and adjacent cervical intraepithelial neoplasia (CIN) 3 in stage 1B squamous cell carcinoma. Of 49 invasive carcinomas, 38.8% had LOH at 11q23.3. Of 36 tumor plugs in LVS, 39% had LOH at 11q23.3. Twenty percent of 15 MFLN demonstrated LOH at 11q23.3. Patients with LOH at 11q23.3 are significantly more likely to have disease recurrence than patients without LOH at 11q23.3 (P =.02). Of 10 foci of CIN 3, none showed LOH at 11q23.3. Although unlikely to have an impact early in carcinogenesis, tumor-suppressor genes located in the region of 11q23.3 appear to be important in tumor progression, facilitating lymphvascular space invasion and, by inference, spread to lymph nodes in squamous cell carcinoma of the cervix.     

Loss of heterozygosity in dysplasia and carcinoma of the gallbladder.

The loss or inactivation of genes at specific chromosomal loci is one of the important mechanisms during the tumor development in humans. To investigate the role of genetic alterations in the carcinogenesis of gallbladder carcinoma, 32 carcinoma cases and 11 dysplasia cases of gallbladder were analyzed for loss of heterozygosity (LOH) and microsatellite instability (MI) on chromosomal regions 3p, 5q, 8p, 9p, 13q, 17p, and 18q with 17 microsatellite markers. Loss of one allele was identified on chromosomes 5q (55%) and 17p (40%) in dysplasias and on chromosomes 3p (52%), 5q (66%), 9p (52%), and 17p (58%) in carcinomas. LOH on chromosomes 13q and 18q was frequent only in advanced stage (III and IV) carcinomas (40% and 31%, respectively). LOH on chromosome 17p was correlated with intranuclear p53 accumulation. LOH on multiple chromosomes was more frequent in advanced carcinomas with metastasis than in cases without metastasis (P < .05). A widespread MI was observed in only one case of carcinoma. We conclude that LOH on 5q is an early change of carcinogenesis in gallbladder and that LOH on 3p and 9p is related to the progression of gallbladder carcinoma LOH on 13q and 18q is likely to be a late event. LOH on 17p occurs not only in dysplasia but also increases during the subsequent stages. Accumulation of LOH may be associated with carcinogenesis of the gallbladder, but the role of MI may not be significant.     

Analysis of intratumoral heterogeneity of chromosome 3p deletions and genetic evidence of polyclonal origin of cervical squamous carcinoma.

Investigation on intratumoral genetic heterogeneity provides an important insight into the roles of genetic alterations in human carcinogenesis and clues to clonal origin of tumors. Intratumoral heterogeneity of genetic changes of cervical cancer has not been described so far. In this study, we analyzed the intratumoral heterogeneity of chromosome 3p deletions and X-chromosome inactivation patterns in multiple microdissected samples from each individual cervical cancer, attempting to understand the roles of 3p deletions in development of cervical cancer and its clonal origin. Totally, 120 normal and lesional samples from 14 cases of fresh cervicalcancers were analyzed. Frequency and patterns of allelic losses of 3p were assessed by polymerase chain reaction (PCR) amplification of 12 microsatellite markers flanking the frequently deleted regions of 3p, followed by Genescan analysis in an ABI 377 DNA sequencer. Loss of heterozygosity was recorded as heterogeneous pattern (LOH present in parts of samples or LOH involving different alleles among different samples) and homogeneous pattern (LOH involving identical alleles in all samples from the tumor). Allelic loss affecting at least one marker was detected in 8 of 14 cases (57%). Allelic losses, both homogeneous and heterogeneous, were frequently detected at FHIT gene region (D3S1300, 40% and 60%; D3S4103, 27.3% and 54.6%), 3p21.3-21.2 (D3S1478, 27.3% and 45.5%), and 3p24.2-22 (D3S1283, 30% and 50%). Seven of eight LOH-positive tumors exhibited homogeneous allelic loss involving at least one of these three 3p loci. Allelic losses were present in the CIN lesions synchronous with invasive lesions positive for LOH. Our findings suggest essential roles of genes on these 3p loci, particularly the FHIT gene in participating in clonal selection and early development of cervical cancer. Most interestingly, with the combination of LOH analysis and X-chromosome inactivation analysis, we provided the first clear genetic evidence of polyclonal origin of cervical invasive cancer in two of eight cases. This finding strongly suggests the importance of field defect (possible human papilloma virus) in cervical carcinogenesis.     

Loss of FHIT protein expression is related to high proliferation, low apoptosis and worse prognosis in non-small-cell lung cancer.

The fragile histidine triad (FHIT) gene, located at chromosome 3p14.2, is deleted in many solid tumors, including lung cancer. Its protein product is presumed to have tumor suppressor function. We investigated the incidence of loss of heterozygosity and loss of FHIT expression in a series of non-small-cell lung carcinomas and its correlation to apoptosis, proliferation index and prognosis. FHIT expression was determined by immunohistochemistry in formalin-fixed paraffin-embedded tissues from 54 squamous cell carcinomas (SCC) and 44 adenocarcinomas (AC) of the lung. DNA from frozen tumor and corresponding normal tissues were analyzed for allelic losses at two loci located internal (D3S1300, D3S1234) and three loci in flanking regions centromeric and telomeric (D3S1210, D3S1312, D3S1313) to the FHIT gene. Apoptosis was detected by terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling (TUNEL). Proliferation index was determined with ki-67 and flow cytometric analysis. We correlated the results with tumor histology, prognosis and some immunohistochemical markers (p53, bcl-2, bax, c-myc, p21(waf1), cyclin-D1). FHIT expression was related to tumor histology: 52 of 54 (96.3%) SCC and 20 of 44 (45.5%) AC were negative for FHIT (P<0.0001). We found LOH at 3p14.2 in 67.8% of the 98 cases: 72.3% of SCC and 61.4% of AC. Loss of FHIT expression was associated with a higher proliferation index (ki-67, P=0.007; flow cytometry, P<0.004) and lower apoptotic index (P=0.018). LOH at FHIT gene were associated to a high proliferation (flow cytometry, P<0.001) and lower apoptotic level (P=0.043). The log-rank test demonstrated a significant inverse correlation (P=0.039) between loss of FHIT expression and patient survival. FHIT plays an important role in the development of non-small-cell lung cancer, particularly in SCC. Loss of FHIT protein is correlated with a high proliferation and low apoptotic index in tumor cells, and is an independent prognostic indicator for the clinical outcome in patients with these tumors.     

Chromosome 3p loss of heterozygosity and mutation analysis of the FHIT and beta-cat genes in squamous cell carcinoma of the head and neck.

AIMS: To study the loss of heterozygosity at the short arm of chromosome 3 in primary tumours from patients with squamous cell carcinoma of the head and neck; to determine whether the FHIT gene, mapped to 3p14.2 and the CTNNB1 (beta-cat) gene, mapped to 3p21, are deleted or mutated in these tumours. METHODS: DNA was extracted from fresh tumours. Loss of heterozygosity was assessed by microsatellite analysis of the following markers: D3S1283 and D3S1286 (3p24), D3S966 (3p21), and D3S1300 (3P14.2). Homozygous deletion was determined by radioactive multiplex polymerase chain reaction of exons 5 and 6 of the FHIT gene. The presence of mutations in FHIT exon 5 and beta-cat exon 3 was studied by single strand conformation polymorphism. RESULTS: 50% of informative cases (25/50) showed loss of heterozygosity for at least one of the 3p markers. 3p21 was the region with the highest rate of allelic deletion (63%). No point mutation was found in FHIT exon 5 or beta-cat exon 3. No case showed homozygous deletion for the FHIT (exons 5 and 6) or the beta-cat exon 3. CONCLUSIONS: The short arm of chromosome 3 is often deleted in the head and neck squamous cell carcinomas. In the remaining alleles of the FHIT or beta-cat genes, no evidence was found for point mutations or deletions, documented in other common carcinomas. Inactivation could occur by different mechanisms such as methylation, or other genes (not studied here) could be target of allelic losses in squamous cell carcinoma of the head and neck.