舌鳞状细胞癌中p73、p63和p53基因的表达

目的：研究p73、p63和p53基因蛋白在舌鳞状细胞癌中的表达及其意义。方法：用免疫组织化学S－P法检测64例舌鳞状细胞癌组织标本p73、p63和p53基因蛋白表达。结果：舌鳞癌中p73、p63和p53基因蛋白阳性率分别为61％、92％和50％。p73蛋白表达与T分类(r=0.344,P=0.057)、区域淋巴结转移（r=0.334,p=0.007)、肿瘤侵袭方式（r=0.340,P=0.060)和不良预后（r=-0.473,P=0.000)相关。p63与所有临床病理特征和预后无关。p53与区域淋巴结转移（r=0.263,P=0.036)和不良预后（r=-0.342,P=0.013)相关。结论：p73和p53表达有助于判断舌鳞癌的生物学行为和预后。p63可能是鳞状上皮源性肿瘤的标记物。     

Biomarkers predictive of lymph node metastases in oral squamous cell carcinoma.

PURPOSE: The ability of oral squamous cell carcinoma to metastasize to lymph nodes does not always show a relationship with clinical staging. The aim of this study was to attempt to define a trend for predictive histopathologic and/or molecular biomarkers in the development of nodal metastasis by analyzing 2 clinically extreme groups. PATIENTS AND METHODS: Patients with small primary tumors (T1, T2) with lymph node metastasis and patients with large primary tumors (T3, T4) without metastatic disease were identified among 315 consecutive cases of primary oral squamous cell carcinoma. Group comparisons were made with use of a Mann-Whitney test, and associations among the variables were assessed with nonparametric and parametric correlational analyses. RESULTS: The degree of keratinization was significantly less in primary tumors with lymph node metastasis (P < or = .01). The degree of keratinization was significantly associated with nuclear pleomorphism (P =.02), number of mitoses (P =.02), stage of invasion (P =.002), and p53 expression (P =.04), independent of clinical stage of the tumor. Other microscopic features and immunohistochemical markers did not differ significantly between the groups (P >.05). CONCLUSION: These data indicate that there still is no single predictive parameter superior to the degree of keratinization to identify patients at risk for the development of regional metastasis.     

MDM_2及p53在口腔疣状癌中的表达研究

目的:研究癌基因蛋白(MDM2)过度表达及p53功能失活与口腔疣状癌发生的相关性。方法:利用免疫组 织化学SP法检测13例口腔疣状癌、10例口腔高分化鳞癌、10例口腔低分化鳞癌组织中的MDM2蛋白及p53蛋白 表达,并分析其相关性。结果:口腔疣状癌中的MDM2蛋白表达与口腔鳞癌间差异无显著性,而其p53蛋白表达 明显低于口腔鳞癌(P<0.01);虽然两者之间无明显相关性(P>0.05),但在13例MDM 蛋白表达阳性的口腔疣 状癌中,仅4例(30.8％)呈现p53阳性,69.2％的病例呈现p53阴性表达。结论:MDM2蛋白过度表达与p53失活 并存可能与口腔疣状癌的发生相关。     

Expression of p53 protein correlates with decreased survival in patients with areca quid chewing and smoking-associated oral squamous cell carcinomas in Taiwan

Expression of p53 protein was examined in oral squamous cell carcinoma (SCC) from patients who were areca quid (AQ) chewers and/or tobacco smokers, using anti-p53 antibodies with an immunoperoxidase technique. Positive p53 stain was observed in 47 of 81 (58%) cases of oral SCC. p53 overexpression was found to higher in patients without AQ chewing and smoking habits than in patients with these two habits (80% vs 52%, P=0.076). No significant correlation was found between p53 expression and the patients' age, sex, cancer location, clinical staging, primary tumor TNM status, or histological differentiation of SCC. The Kaplan-Meier analysis showed that the prognosis for patients with p53-negative tumors was significantly better than that for patients with p53-positive tumors (P<0.05). A significant correlation was also observed between positive lymph node status and poor prognosis (P<0.05). These results suggest that p53 may serve as an adjuvant marker of poor survival in patients with oral SCCs in Taiwan.     

Elevated ras p21 expression in oral premalignant lesions and squamous cell carcinomas in Taiwan

Expression of ras p21 oncoproteins was examined in histological sections of oral squamous cell carcinoma (SCC), epithelial dysplasia, epithelial hyperkeratosis and normal oral mucosa using antibodies to ras p21 with an immunoperoxidase technique. Ras p21-positive staining was found in 47 of 51 (92.2%) cases of oral SCC, 4 of 4 (100%) cases of epithelial dysplasia, 7 of 7 (100%) cases of epithelial hyperkeratosis, and 1 of 6 (16.7%) cases of normal oral mucosa. The positive staining rate of ras p21 in oral SCC, epithelial dysplasia or epithelial hyperkeratosis was significantly higher than that in normal oral mucosa (P<0.05). No correlation was found between ras p21 expression and patient age, tumour location, tumour size, clinical staging or histological differentiation of SCC. However, a significant positive correlation was found between ras p21 expression and patients' sex (P<0.05) or regional lymph node status (P<0.05). A significant positive correlation was also discovered between ras p21 expression and patients' smoking habits (P<0.01), as well as daily or total betel quid (BQ) consumption (P<0.05). Of the 47 immunostain-positive SCC patients, specimens from 6 patients were also obtained after chemotherapy, when ras p21 expression was found to be reduced. These results indicate that ras p21 over expression may play an important role in the initiation and progression of oral SCCs in patients who are smokers and BQ chewers.     

Prognostic significance of perineural invasion in oral and oropharyngeal carcinoma

OBJECTIVE: To evaluate the occurrence and prognostic significance of perineural invasion (PNI) in squamous cell carcinomas (SCC) of the oral cavity and oropharynx. STUDY DESIGN: A retrospective study of 101 patients with previously untreated SCC of the oral cavity and oropharynx was undertaken to evaluate the occurrence and prognostic significance of PNI in relation to local recurrence, regional recurrence, distant metastasis and survival. The logistic regression test was used for univariate and multivariate analyses. Actuarial survival curves were determined using the Kaplan-Meier method. RESULTS: PNI was present in 26 (25.7%) of 101 patients and was significantly associated with tumor differentiation, lymph node metastasis, and depth of invasion. Univariate analyses showed PNI was associated with local recurrence (P=.005), regional recurrence (P=.007), and distant metastasis (P=.013). In multivariate analysis, PNI was significantly associated with regional recurrence (P=.033) and distant metastasis (P=.021), but not with local recurrence (P=.109). The 5-year disease-specific survival for patients with and without PNI was 56.6% and 94.6%, respectively (P<.0001). CONCLUSION: PNI is an important predictor for outcome of patients with SCC of the oral cavity and oropharynx.     

Prognostic role of p21WAF1 expression in areca quid chewing and smoking-associated oral squamous cell carcinoma in Taiwan.

BACKGROUND: Alterations in p21WAF1 protein expression have been observed in a wide variety of human cancers by immunohistochemistry, and both decreased and increased levels of p21WAF1 protein expression have been shown to correlate with poor prognosis. METHOD: To examine the relation between p21WAF1 protein expression and prognosis in oral squamous cell carcinomas (SCCs), we performed an immunohistochemical study with antip21WAF1 antibody on 43 oral SCCs. Immunostaining results were then correlated with p53 protein levels, clinicopathological parameters of the tumors and overall patient survival. RESULTS: Of the 43 patients, 31 (72%) had tumors with positive p21WAF1 nuclear staining and 27 (63%) had tumors with p53 nuclear staining. There was no significant correlation between p21WAF1 and p53 protein expressions and both mutant p53-containing oral SCCs overexpressed p21WAF1 protein. In addition, no significant correlation was found between the p21WAF1 expression and the patients' age, sex, oral habit, cancer location, or primary tumor TNM status at the time of initial presentation. The Kaplan-Meier analysis showed a significant correlation between p21WAF1 protein overexpression and poor patient overall survival (P = 0.049). When p53 and p21WAF1 were evaluated together, the 5-year overall survival was lowest in p53(+)-p21WAF1(+) patients and highest in p53(-)-p21WAF1(-) patients (P = 0.057). CONCLUSION: Combined evaluation of p21WAF1 and p53 expressions may be useful in estimating the prognosis of patients with oral SCCs in Taiwan.     

survivin在口腔鳞状细胞癌中的表达及其与 bcl-2,P53,bax表达之间的关系

目的初步探讨口腔鳞状细胞癌中凋亡抑制蛋白survivin的表达和临床意义,以及survivin的表达与bcl-2,P53,bax表达之间的关系。方法采用免疫组化二步法,DAB染色。27例口腔鳞癌和1例乳腺癌阳性对照病例手术前均未进行放疗、化疗或生物治疗。结果27例口腔鳞癌组织中survivin阳性表达率为88.89%(24/27),11例正常组织中survivin没有表达。在口腔鳞癌不同的临床病理分级survivin的表达有差异(P<0.05),其表达随着临床病理分级的增加而增加。Survivin在有淋巴结转移者阳性表达率(100%)高于无淋巴结转移者(82.35%),但统计学比较无差异(P>0.05)。口腔鳞癌中survivin的表达在不同的年龄组和性别间无差异(P>0.05),而在不同部位的鳞癌中表达有差异(P<0.05)。口腔鳞癌中survivin的表达和bcl-2,突变型P53的表达成正相关,(P<0.05),而与bax的表达成负相关,(P<0.05)。结论①Survivin可作为口腔鳞癌诊断的一项重要指标;②Survivin可作为口腔鳞癌基因治疗和免疫治疗的靶分子;③在口腔鳞癌基因治疗方面可以考虑协同抑制突变型P53和bcl-2的表达,或者提高bax的表达来提高疗效。     

尿激酶型纤溶酶原激活物在口腔鳞癌中的表达及意义

目的　探讨尿激酶型纤溶酶原激活物(UPA)在口腔鳞癌中的表达及与侵袭、转移、预后的关系。方法　采用免疫组织化学LsAB法检测80例口腔鳞癌、10例口腔正常粘膜、10例口腔粘膜白斑中UPA的表达。结果　口腔鳞癌中UPA表达明显高于口腔正常粘膜和口腔白斑。口腔鳞癌中UPA的表达与淋巴结转移、预后、生长方式存在相关关系;有转移者表达明显高于无转移者,预后差者表达明显高于预后好者,浸润型生长方式者表达高于外生型和溃疡型生长方式者。结论　UPA表达与口腔鳞癌的侵袭、转移关系密切,有望在临床上成为判断侵袭、转移和预后指标之一。     

Serum p53 antibodies as a prognostic indicator in oral squamous cell carcinoma

The purpose of the present study was to investigate the clinical usefulness of the detection of serum p53 antibodies (p53 Abs) in patients with oral squamous cell carcinoma (SCC). Preoperative values of p53 Abs were measured by enzyme-linked immunosorbent assay in 113 patients with primary oral SCC and seropositive patients were reevaluated postoperatively. The positivity rate of p53 Abs was 16%, and the 5-year survival rate of patients positive for p53 Abs was significantly lower than that of patients negative for p53 Abs (56.2% vs. 80.7%; P = 0.018). The preoperative presence of p53 Abs was found to be an independent prognostic factor in a multivariate analysis (P = 0.028, hazards ratio = 3.34), and its positivity was significantly related to secondary cervical lymph node metastases (P = 0.029). Six of nine patients who remained seropositive for p53 Abs through the disease course and the one with seropositive reversion from temporary negative status developed treatment failure. Therefore, the detection of p53 Abs in the serum of patients with SCC may be a useful prognostic marker.     

Late (>5 years) regional lymph node metastasis of oral squamous cell carcinoma (SCC), proven by p53 mutation analysis.

BACKGROUND: A late (>5 years) neck nodal metastasis of oral cancer, poses a problem to the clinician: is it a late metastasis or a metastasis of a (unknown) second primary tumour? METHODS: A 50-year-old male was seen with a contralateral lymph node metastasis, 5(1/2) years after treatment of a pT2N1M0 carcinoma in the floor of the mouth. Both the late metastasis and the original tumour specimen were analysed for p53 mutations. RESULTS: Both specimens showed an identical p53 mutation, thereby confirming the lymph node to be a late metastasis. CONCLUSIONS: A lymph node metastasis can occur more than 5 years after treatment of an oral squamous cell carcinoma. p53 mutation analysis is of help to discriminate it from a second primary tumour.     

p53 aberrations in oral submucous fibrosis and oral squamous cell carcinoma detected by immunocytochemistry and PCR-SSCP

Trivedy C, Warnakulasuriya KAAS, Tavassoli M, Steingrimsdottir H, Penhallow J, Maher R, Johnson NW: p53 aberrations in oral submucous fibrosis and oral squamous cell carcinoma detected by immunocytochemistry and PCR-SSCP. J Oral Pathol Med 1998; 27: 72–7. © Munksgaard, 1998.
An archival series of oral biopsies from Karachi, Pakistan, consisting of 21 cases of oral submucous fibrosis (OSF) and 27 cases of squamous cell carcinoma (SCC), of which 6 had arisen from OSF, were used to examine the aberrations in the structure and expression of the p53 tumour suppressor gene. The PCR-SSCP method was used for mutation analysis of exons 2–9, and (over)expression of p53 protein was detected by immunocytochemistry using monoclonal antibody DO 7. Positive immunostaining was observed in 15/20 (75%) of OSF specimens, 3/6 (50%) of SCC arising from OSF and 14/21 (67%) of SCC not arising from OSF. Mobility shifts in SSCP indicative of a mutation in p53 or loss of heterozygosity (deletion of a band) were seen in 13/21 cases of OSF and 15/27 cases of SCC. There was concordance between immunocytochemistry and SSCP results in a majority (33/48) of samples. Though the number of analysed SCC cases arising from OSF was limited, the results suggest that p53 mutation/protein stabilisation may play a part in the pathogenesis of OSF and its progression to SCC.     

口腔鳞状细胞癌中p27与Skp2蛋白表达及其意义的初步观察

目的:探讨p27与Skp2蛋白在口腔鳞状细胞癌组织中的表达及其与口腔鳞状细胞癌临床病理之间的相互关系。方法:免疫组化SP法检测p27、Skp2蛋白在69例口腔鳞状细胞癌和12例正常口腔黏膜组织中的表达情况,并分析其与患者的年龄、性别、肿瘤的部位、临床分期、病理分级、颈淋巴结转移之间的相关性。结果:口腔鳞状细胞癌中p27蛋白的阳性率63.73%明显低于正常黏膜组织92.72%(P<0.05),Skp2蛋白在口腔鳞状细胞癌中的阳性率19.02%明显高于正常黏膜组织4.24%(P<0.05)。p27蛋白阳性表达率与肿瘤的临床分期、病理分级、颈淋巴结转移呈负相关(P<0.05),Skp2蛋白阳性表达率则与以上临床病理特征呈正相关(P<0.05);二者的阳性表达率与口腔鳞状细胞癌患者的年龄、性别、肿瘤部位无关(P>0.05)。p27蛋白在口腔鳞状细胞癌中的表达与Skp2蛋白呈负相关(P<0.05)。结论:Skp2蛋白表达与靶蛋白细胞周期抑制因子p27降解相关,可能参与了口腔鳞状细胞癌的发生、发展。联合检测p27和Skp2蛋白表达有助于判断口腔鳞状细胞癌的恶性程度和预后。     

口腔白斑和鳞癌中P_(53)基因突变的PCR─SSCP分析

本实验应用聚合酶链反应－单链构象多态性（PCR—SSCP）分析技术对5例正常口腔粘膜、22例白斑和30例鳞癌中P53基因突变情况进行检测。结果表明，轻、中、重度异常增生白斑，无和有淋巴结转移鳞癌P53突变率为12．5％，37．5％，50．0％，64．3％和75．0％，正常粘膜无一例阳性，白斑和鳞癌间P53变化有显著性差异（P＜0．05）。P53突变与鳞癌有否淋巴结转移无关。     

p53 aberrations in oral sub mucous fibrosis and oral cancer detected by immunohistochemistry.

Study of expression of p53 oncoprotein in several precancerous and cancer have been done, but only one literature is available regarding p53 expression in Oral Sub Mucous Fibrosis (OMSF), hence this study was taken up (i) to determine the expression of aberrant p53 in Oral Sub Mucous Fibrosis (OSMF) and Oral Squamous cell carcinoma (SCC) patients. (ii)To study correlation if any between p53 expression and degree of dysplasia in OSMF and SCC patients and (iii)To study correlation if any between p53 expression and habits in OSMF and SCC patients. Study Design consists of biopsy specimens of 38 cases of OSMF and 37 cases of Squamous cell carcinoma were subjected for staining by immunohistochemistry for p53 protein using LSAB visualization system kit. Clinical details along with habits were recorded and the data analyzed with t- test and chi- square test. Results of the study reveals 18 cases of OSMF and 26 cases of SCC were positive for p53 protein. Only 4 cases of SCC showed (++)grade and the rest all had (+)grade. Out of 75 patients, 65 had the habit of smoking and chewing, 4 patients history of habit was not known. Among patients with habits (65), 40 specimens were +ve for p53 stain and 2 out of 6 without history of habit, 2 out of 4 unknown history of habit took up p53 stain. To conclude study showed higher percentage of p53 positive cells in oral cancer cases when compared to oral sub mucous fibrosis cases. It suggests p53 expression may correlate with increase in dysplasia or malignant transformation. Both smoking and chewing habits had a significant role in p53 positive expression.     

口腔肿瘤中血管内皮细胞生长因子表达的研究

目的研究口腔肿瘤组织中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的表达情况,探讨其与肿瘤性质及恶性进展的关系。方法采用免疫组化SABC法检测86例口腔肿瘤组织中VEG蛋白的表达情况。结果本组VEGF的总表达率为33%(28/86),鳞癌中VEGF的表达率显著高于乳头状瘤和腮腺混合瘤(P<0.001)。VEGF表达与肿瘤分化程度呈负相关(列联系数r=-0.40,P<0.05);与淋巴结转移呈正相关(列联系数r=0.39,P<0.05)。结论口腔恶性肿瘤较良性肿瘤组织中VEGF的表达率显著增高,VEGF表达可能有助于口腔良恶性肿瘤的鉴别。鳞癌组织中VEGF表达与肿瘤的分化程度和淋巴结转移有关,VEGF表达的增加促进了口腔鳞癌的恶性进展。     

口腔鳞癌中Rb/cyclinD1/p16通路表达及其病理意义

目的：探讨口腔鳞癌(OSCC)中Rb／cyclinD1／p16通路表达及其病理意义。方法：使用免疫组化方法在37例OSCC标本中检测Rb、cyclinD1、p16蛋白表达,并与患者临床病理参数进行相关性分析。结果：Rb、p16、cyclinD1阳性表达率分别为76％、49％和57％;Rb和p16表达呈负相关(P=0．02);cyclinD1表达与肿瘤大小(P=0．02)和淋巴结转移(P=0．01)呈正相关;p16表达与年龄呈负相关(P=0．02)。结论：1)OSCC中和Rb和p16之间可能存在的调控机制;2）p16缺失是OSCC发生中的早期事件;3)cyclinD1对肿瘤的生长作用大于对肿瘤的发生作用,与OSCC的增殖和淋巴结转移关系密切,并可能作为标志物对OSCC的预后和转移作出评估。     

Expression of MMP-7 and MT1-MMP in oral squamous cell carcinoma as predictive indicator for tumor invasion and prognosis

BACKGROUND: Squamous cell carcinoma of the oral cavity is a highly invasive neoplasm that spreads locally and metastasizes to regional lymph nodes. This process involves multiple proteolytic enzymes including matrilysin (MMP-7) and membrane type I-matrix metalloproteinase (MT1-MMP). This study was designed to explore the association between MMP-7 and MT1-MMP in the invasiveness and prognosis of oral squamous cell carcinoma (OSCC). METHODS: About 4-microM, formalin-fixed, paraffin-embedded tissue sections from 69 patients with OSCC were immunohistochemically studied using specific antibodies against MMP-7 and MT1-MMP proteins. Immunostaining was semiquantitatively scored, and results were correlated with histologic and clinical variables including clinical behavior and survival. RESULTS: MMP-7 was observed only in cancer cells, and MT1-MMP in both tumoral tissue and stroma. MMP-7 expression was significantly correlated with lymph node metastasis (P = 0.03; RR = 3.2). MT1-MMP showed a significant association with TIMP-2 (in N+ cases) and p53 expression (P = 0.01). MMP-7 and MT1-MMP displayed a survival relevance, and in multivariate analysis they were independent prognostic indicators, particularly in neck node-positive cases.     

颊粘膜鳞癌中p27~(Kipl)基因的蛋白质表达及临床意义

目的　分析口腔颊癌癌变过程中 p2 7蛋白表达与临床病理资料及预后的关系 ,阐明 p2 7蛋白检测在颊癌诊断与治疗中的临床意义。方法　回顾性研究 40例颊癌、2 0例白斑及 7例正常颊粘膜 p2 7蛋白表达情况 ,采用 SP法根据染色指标计数 ,并利用 Cox比例风险模型进行生存多因素分析。结果　 p2 7多分布于上皮细胞核和胞浆 ,正常组织和不伴上皮异常增生的白斑表达最强 ,伴上皮异常增生的白斑及颊癌分化较好的强阳性表达较多 ,分化较差的颊癌 p2 7表达最弱 ,甚至不表达。单因素生存分析表明 ,p2 7表达、区域淋巴结和远处转移与生存期显著相关 ,多因素 Cox回归分析表明 p2 7蛋白表达可作为辅助性颊癌预后指标。结论　 p2 7蛋白表达与口腔肿瘤的发生发展有密切关系 ,它与肿瘤的侵袭性生长及预后密切相关 ,可作为一个新的辅助性预后指标     

口腔白斑和鳞癌中P_(53)、C-myc基因的免疫组化研究

本实验应用免疫组化－链霉素抗生物素蛋白－过氧化酶连接法（ＳＰ）对正常口腔粘膜、白斑和鳞癌中Ｐ５３、Ｃ－ｍｙｃ基因的表达进行研究．结果表明：正常粘膜无一例阳性；轻、中、重度异常增生白斑和鳞癌Ｐ５３蛋白表达率为１２．５％，２５．０％，３３．３％和５０．０％；Ｃ－ｍｙｃ表达率为０．０％，１２．５％，１６．７％和２３．３％．白斑和鳞癌间Ｐ５３变化有显著性差异，Ｃ－ｍｙｃ表达无显著性差异．此两基因的表达与鳞癌有否淋巴结转移无关，且在鳞癌发生中有协同作用