鼻咽癌细胞增殖因素的检测与预后的相关性

目的：探讨鼻咽癌细胞中细胞增殖因素cyclinD1、c-erbB-2、Ki-67、PCNA蛋白的表达及其与鼻咽癌预后的关系。方法：以免疫组化S－P法检测212例鼻咽癌组织cyclinD1、c-erbB-2,Ki-67和PCNA蛋白的表型。结果：cyclinD1蛋白表达阳性率81．25％，表达程度与临床分期、原发灶范围、鼻咽部复发呈正相关，与患者5年生存率呈负相关。c-erbB-2蛋白表达阳性率为95％，表达程度与临床分期、原发灶、颈部转移灶、局部复发及远处转移呈正相关，与5年生存率呈负相关。Ki-67蛋白表达阳性率为97％，表达程度与临床分期、原发灶、颈部转移灶呈正相关。PCNA蛋白表达阳性率为99％。在cyclinD1，c-erbB-2,Ki-67及PCNA4因素中除Ki-67与PCNA无明显相关性外，其他因素间均存在明显的相关性。多因素分析表明对鼻咽癌颈后有显著影响的因素是cyclinD1、c-erbB-2。结论：cyclinD1、c-erbB-2与鼻咽癌的预后有较好的相关性，对于cyclinD1、c-erbB-2高表达的患者，应采取综合治疗。

Correlation between factor of cell proliferation and prognosis in nasopharnygeal carcinoma(NPC)

Purpose To evaluate the expression of cyclin D1, c erbB 2, Ki 67, PCNA in NPC, and to select the best prognostic factor in NPC. Method Expression of cyclin D1, c erbB 2, Ki 67, and PCNA was determined by S P immunohistochemical technique in 212 consecutive patients with nasopharyngeal carcinoma. Results The positive rate of expression of cyclin D1 was 81 25%. The intensity of the cyclin D1 expression had a positive relationship with the clinical stage the invasive extent of nasopharyngeal foci and the relapse rate in nasopharynx. There was a negative correlation between the intensity of cyclin D1 and the five years survival rate. The positive rate of expression of c erbB 2 was 95%. The intensity of the c erbB 2 expression had a positive relationship with the clinical stage, the relapse of nasopharyngeal foci, neck lymph node metastasis, and distant metastasis. With the increase of c erbB 2 expression, the five years survival rate decreased.The positive rate of expression of Ki 67 was 97%. Expression of Ki 67 had a positive relationship with clinical stage, nasopharyngeal recurrence and neck metastasis. The positive rate of expression of PCNA was 99%. Correlational analysis of cyclin D1, c erbB 2, Ki 67 and PCNA showed that although Ki 67 and PCNA did not seem to correlate, obvious correlation existed between the other factors. Multi factor analysis found that cyclin D1 and c erbB 2 were factors that strongly influence prognosis.Conclusions The factors of cell proliferation, cyclin D1 and c erbB 2, have high correlation with the prognosis of nasopharyngeal carcinoma. Patients with high expression of cyclin D1 and c erbB 2 should be treated with combination chemotherapy.