p73和PCNA的表达与喉鳞状细胞癌的预后

目的：探讨喉鳞状细胞癌（LSCC）中p73、增殖细胞核抗原（PCNA）基因的表达与患者临床、病理参数和预后的关系。方法：采用免疫组织化学SABC技术检测65例LSCC组织及23例癌旁组织中p73、PCNA基因的表达情况。结果：p73、PCNA蛋自在65例LSCC组织中的表达水平较23例癌旁组织明显增强（均P〈0．05）。65例LSCC组织中，p73蛋自在TNM分期Ⅲ～Ⅳ期、远处转移及复发患者中的表达水平较Ⅰ～Ⅱ期、无转移及初发患者表达增强（P〈O．05）。PCNA蛋自在TNM分期Ⅲ～Ⅳ期患者、低分化癌、复发患者和有颈淋巴结转移及远处转移患者中的表达水平较Ⅰ～Ⅱ期、高中分化、初发患者和无转移患者中的表达增强（P〈O，05）。PCNA蛋白的表达与患者预后明显相关。经Cox比例风险模型进行分析，PCNA表达是患者预后不良的重要指标（其相对危险度RR=2.43，P〈0．05）。LSCC组织中p73、PCNA的基因表达存在正相关性（P〈0、05）。结论：p73蛋自在LSCC的发生、发展过程中可能扮演了癌基因的角色。PCNA蛋白的表达与LSCC的危险性存在密切关系，可作为判断LSCC患者预后的重要指标。LSCC中p73、PCNA的表达存在正相关关系。

Expression and prognosis significance of p73 and PCNA in laryngeal squamous cell carcinoma

OBJECTIVE: This study was designed to investigate the expressionof p73 and Prolife Rating Cell Nuclear Antigen(PCNA) and their association with clinical, histologic characteristics and prognosis in LSCC. METHOD: p73 protein and PCNA protein were examined by using immunochistochemical SABC staining method in 65 cases of LSCC and in 23 adjacency carcinoma cases. RESULT: p73 protein and PCNA protein in LSCC shows stronger expression than that in adjacency carcinoma, which is statistically significant(P <0.05). p73 protein positive expression shows stronger in stage III approximately IVof LSCC than that in stage I approximately II (P<0.05); it more often appears in recurrent cases than in primary cases( P <0.05). And p73 protein positive expression with distant metastasis was stronger than that in LSCC without distant metastasis(P <0.05). PCNA protein positive expression was stronger in stage III approximately IV of LSCC than that in stage I approximately II (P <0.05); it more often appears in recurrent cases than in primary cases(P <0.05). PCNA protein positive expression more frequently appears in poor differentiation of LSCC, compared to well/mediate differentiation(P <0.05); PCNA positive expression in cases with cervical lymph node metastasis and distant metastasis was stronger than that without metastasis(P <0.05). PCNA expression had a significantly stronger in patients whose survival time over 5 years than that in patients whose survival time less than 5 years(P <0.05). Analysing with multivariate Cox, the expression of PCNA is an important marker of poor prognosis(RR= 2.43, P <0.05). CONCLUSION: p73 protein positive expression may play a part in LSCC progression and function as an oncogene in the development of LSCC. PCNA positive expression was closely linked with the risk of LSCC; it can be an important predictor on evaluating the prognosis of LSCC. There was positive correlation existing between p73 protein and PCNA protein expression in LSCC.