头颈鳞癌p53、Bcl-2及P-gp表达在治疗中的作用

目的 检测突变型p53、Bcl-2及P-gp蛋白在头颈鳞癌中的表达,探讨其在治疗中的作用.方法 97例头颈鳞癌中口咽癌18例、下咽癌27例、声门上喉癌52例,采用S-P法检测癌组织中p53、Bcl-2及P-gp蛋白表达,并结合治疗结果进行统计分析.结果 突变型p53、Bcl-2及P-gp蛋白在头颈鳞癌中的阳性表达率分别为69.07﹪、46.39﹪、50.52﹪.突变型p53蛋白阳性与阴性累计五年生存率分别为38.43﹪和75.86﹪.P-gP蛋白阳性与阴性分别为35.23﹪和63.15﹪,两者对比有统计学意义(P＜0.05).在单纯手术和术后放疗、化疗两组中,突变型p53蛋白阳性与阴性的五年生存率分别为40.77﹪和80.00﹪、25.63﹪和61.90﹪,对比均有统计学意义(P＜0.05).术后放疗、化疗组中Bcl-2和P-gp蛋白阳性与阴性的五年生存率分别为23.35﹪和48.83﹪、31.43﹪和60.53﹪,差别有统计学意义.结论 突变型p53、Bcl-2、P-gp蛋白阳性表达是抵抗放疗或化疗的生物学指标,在预测放疗、化疗敏感性方面有一定作用.

Effect expression of p53,Bcl-2 and P-gp protein in treatment head and neck squamous carcinoma

Objective To detect expression of mutational p53,Bcl-2 and P-gp protein in head and neck squamous cancer,and to approach the effect of that.Methods Among 97 cases of head and neck squamous carcinomas,oropharyngeal cancer were 18 cases,hypopharyngeal cancer 27 cases,superglottic laryngeal cancer 52 cases.PS methods were used to detect the expression of p53,Bcl-2 and P-gp protein in squamous cancer.Statistical analysis was performed with treatment results.Results The positive rate of mutational p53,Bcl-2 and P-gp proteins in head and neck squamous cancer were 69.07%,46.39% and 50.52% respectively.5 years accumulative survival rates of positive and negative rates of mutational p53 were 38.43% and 75.86% respectively.5 years accumulative survival rates of positive and negative rates of mutational P-gp protein were 35.23% and 63.15% respectively.Their comparison between 5 years accumulative survival rates had remarkable difference(P<0.05).In surgical and postoperative radiotherapy of chemotherapy groups,5 years survival rates of positive and negative mutational p53 protein were 40.77% and 80.00%,25.63% and 61.90%,respectively.Their comparison between positive and negative expression had statistical significance(P<0.05).In postoperative radiotherapy and chemotherapy group,5 year survival rates of positive and negative Bcl-2 and P-gp protein were 23.35% and 48.83%,31.43% and 60.53% respectively,and had statistical significance.In positive expression of Bcl-2,the rate of lymph node metastasis was 68.89%.Conclusion The positive expression of mutational p53,Bcl-2 and P-gp are biological index of resisting radiotherapy or chemotherapy,and play some role in calculating sensitivity of radiotherapy and chemotherapy.