进展期上颌窦鳞癌P53蛋白的表达与放疗敏感性分析

目的 探讨进展期上颌窦鳞癌中P53蛋白的表达与放疗敏感性的关系,进而指导临床的治疗.方法 收集中山大学第一附属医院及中山大学肿瘤医院于1992年～2001年收治的符合入选标准的上颌窦鳞癌26例.S-P法检测标本中P53蛋白的表达.随访2年.分别于综合治疗后6、12、18及24个月内统计患者肿瘤局部复发情况.X2检验及Fisher's精确概率计算法检测分析26例上颌窦鳞癌中P53蛋白的表达与肿瘤局部复发情况.结果 26例上颌窦鳞癌中P53蛋白高表达17例(占65%),低表达9例(占35%).P53蛋白高表达组中接受综合治疗后6个月内有1例肿瘤在局部复发(5.9%);～12个月内有6例(35.3%);～18个月内有3例(17.6%);～24个月内有2例(11.8%);P53蛋白低表达组中6及12个月内无肿瘤局部复发;18个月内有1例(11.1%);19～24个月内有5例(55.6%).在综合治疗后18个月内,2组肿瘤局部复发差异有统计学意义(P＜0.05),而在24个月内差异无统计学意义(P＞0.05).结论 在接受了根治性手术+术后辅助性放疗的进展期上颌窦鳞癌中,P53蛋白的表达与残存的处于细胞有丝分裂期的肿瘤细胞的放疗敏感性有关.术后的辅助性放疗对残存的处于静止期的肿瘤细胞作用有限.

An analysis of the expression of P53 protein and the radiosensitlvity in patients with advanced maxmary squamous ceH carcinoma

Objective To explore the relationship between the expression of P53 protein and the radiosensitivity in patients with advanced maxillary squamous cell carcinoma.Methods An immunohistochomical method wag used to detect the expression of P53 protein in patients with advanced maxillary squamous cell carcinoma.The follow up time was 2 years.The local recurrence of the patients having been treated with radical surgery and affiliated radiotheraphy were analyzed.Results The overexpression of P53 protein in 26 cages was 65.4% (17/26).In the P53 overexpression group,the local recurrence after systiem therapy wag occurred in one case within 6 months,6 cages between 7～12 months.3 cages between 13～18 months and 2 cases between 19～24 months.In the P53 low expression group,there were no recurrence within 6 and 12 months and one case ocurred within 18 months.5 cages between 19～24 months.The difference of recurrence within 18 months after system therapy between the expression of P53 Wag statistically significant(P＜0.05),but it Wag not significant for those within 24 months(P＞0.05).Conclusions The expression of P53 protein Wag correlated with the radiosensitivity in patient with advaneed maxillary squamous cell carciaoma,especially for the resid.rod cells in mitosis phase.The affiliated radiotherapy after radical surgery Wag limited effect.