喉鳞状细胞癌P53蛋白表达和基因突变

目的：探讨喉鳞癌P53蛋白表达和基因移码突变情况。方法：采用SP法检测31例喉鳞癌的P53蛋白表达；人工微切割—PCR—异源双链分析法检测ll例P53蛋白阴性标本第5、6、7、8外显子的移码突变。结果：免疫组织化学显示P53总阳性率为64．5％。T1、T2期阳性率43．8％，T3、T4期为86．7％；有和无淋巴结转移的分别为91．7％、47．4％(P＜0．05)；高分化、中分化及低分化鳞癌中P53蛋白阳性率分别为45．5％(5／11)、66、7％(8／12)、87．5％(7／8)。异源双链分析法分析1例第5外显子和1例第7外显子阳性。结论：在喉鳞癌中，P53蛋白阳性表达多见于T3及T4期肿瘤及有颈淋巴结转移者；p53基因突变率随肿瘤分化程度的降低而升高。

Alteration of P53 protein expression and p53 gene in laryngeal carcinoma

Objective: To study the prevalence of P53 protein expression and p53 gene mutation in laryngeal carcinoma.Methods:Using immunohistochemistry P53 expression was detected in 31 patients with laryngeal carcinoma.In 11 P53 negative patients,microdissection-PCR-HA technique was used to determine mutation in p53 exon 5,6,7,8. Results:Among the 31 patients tested with immunostaining, the overall average positive rate was 64.5%. Positive rates for T3 and T4 tumors were 86.7% vs 43.8% in T1 and T2 tumors.The positive rate was 91.7% in those with cervical node metastasis vs 47.4% in those without lymph node metastasis. The positive P53 immunostaining was more frequently found in poor-differentiated carcinoma (87.5%) and moderate-differentiated carcinoma (66.7%),than in well-differentiated carcinoma(45.5%).The abnormal exon 5 or 7 of p53 gene were detected in 2 out of 11 cases,in which P53 was negative.Conclusion:P53 gene mutation is related with TNM grading and cervical lymph node metastasis in laryngeal carcinoma.P53 mutation tents to be correlated to pathologic grading.