鼻腔-鼻窦内翻性乳头状瘤组织PCNA、bcl-2和p53的表达活性观察

目的分别检测鼻腔/鼻窦内翻性乳头状瘤（nasal invered papilloma,IP）、内翻性乳头状瘤伴不典型增生（IP with dysplasia,ID）和内翻性乳头状瘤伴恶变组织（IP with squamous cell carcinoma,SCC）中的增殖细胞核抗原、bcl-2和p53表达活性,探讨内翻性乳头状瘤恶变的可能机制。方法内翻性乳头状瘤31例、内翻性乳头状瘤伴不典型增生10例、内翻性乳头状瘤恶变5例,取活检组织,应用免疫组织化学方法分别检测增殖细胞核抗原、bcl-2和p53的表达活性,分析其病理意义。结果内翻性乳头状瘤、内翻性乳头状瘤伴不典型增生组织p53表达分别为0%、40.0%,PCNA的表达分别为25.81%、60.0%,bcl-2的表达分别为29.03%、70.0%。二者差异的组间比较以及内翻性乳头状瘤与SCC的组间比较差异有统计学意义,而内翻性乳头状瘤伴不典型增生与SCC的组间比较差异无统计学意义。结论鼻腔/鼻窦内翻性乳头状瘤的恶变,可能是其细胞增殖活性升高与凋亡活性抑制共同作用的结果。

Expressive activities of PCNA,bcl-2 and p53 in the tissues of inverting papilloma in nasal cavity and sinuses

Objective To explore the possible mechanisms underlying the malignant transformation of inverting papilloma through analyzing the expressive activities of proliferating cell nuclear antigen （PCNA）, bcl-2 and p53 in the tissues of inverting papilloma （IP）, IP accompanied with dysplasia and IP accompanied with malignant transformation respectively in nasal cavity and/or sinuses in a comparative way. Methods Included in this study were 31 cases of IP, 10 cases of IP with dysplasia and 5 cases of IP with malignant transformation to squamous cell carcinoma （SCC）, all in nasal and/or sinuses and with their tumor tissue samples collected during the operation. Then, immunohistochemical staining procedures were taken to determine the expressive activities of PCNA, bcl-2 and p53 in the tissue samples respectively to explore their pathological implications in the developing process of malignant transformation from inverting papilloma. Results In the tissues of IP and IP with dysplasia, the positive expression rates of p53 were 0% and 40.0%, that of PCNA were 25.81% and 60.0%, and that of bcl-2 were 29.03% and 70.0% respectively, with very significant differences in these indicators between these two kinds of tissue samples. However, there were no such statistical differences present in these same indexes between the two kinds of tissues of IP with dysplasia and ones with malignant transformation to SCC. Conclusions The combined pathological effects of abnormally elevated activity of proliferation and declined activity of apoptosis may be the possible mechanisms underlying the malignant transformation from IP in nasal cavity and/or sinuses.