p21WAF1/CIP1和抑制增殖细胞核抗原的表达与下咽癌及喉癌的临床关系

目的：探讨p21^WAF1/CIP1和抑制增殖细胞核抗原(PCNA)的表达与下咽癌、喉癌的分级、转移及预后的关系，了解p21^WAF1/CIP1在下咽癌、喉癌发生、发展中的作用以及与PCNA的相关性。方法：对45例下咽癌、25例声门上型喉癌、23例声门型喉癌标本，用Envision HIS的方法检测p21^WAF1/CIP1、PCNA的表达情况，并分析p21^WAF1/CIP1表达与下咽癌、喉癌临床病理特征、转移、复发和预后的关系。结果：p21^WAF1/CIP1阳性表达率为51.6％(48／93)，PCNA的阳性表达率为97.8％(91／93)；p21^WAF1/CIP1表达与下咽癌、喉癌患者的年龄、性别、肿瘤分化、远处转移及复发无显著性相关，与肿瘤的原发部位的T分期有显著性相关；p2^WAF1/CIP1的表达还与肿瘤的预后有显著性相关；而PCNA与肿瘤的临床分期及淋巴转移有显著性相关，p21^WAF1/CIP1与PCNA的表达具有相关性。结论：p21^WAF1/CIP1、PCNA是预测肿瘤浸润范围及转移的良好指标，p21^WAF1/CIP1对预后的判定具有一定的指导意义。

The expression of p21WAF1/CIP1 and PCNA in hypopharyngeal and laryngeal squamous cell carcinomas

Objective:In order to evaluate the significance of the expression of p21 WAF1/CIP1 and PCNA (proliferating cell nuclear antigen) in hypopharyngeal and laryngeal squamous cell carcinoma.Method:Ninety-three patients who accepted operations for hypopharyngeal and laryngeal squamous cell carcinoma from 1998 to 2003 were included in this study, 45 cases were hypopharyngeal cancer,25 cases were supraglottic cancer,23 cases were glottic cancer.The clinical and histopathological features of these patients were reviewed.The Envision immunohistochemistry method was utilized to stain these faculties.Result:The expressian of p21 WAF1/CIP1 had no correlate with differentiation, N stage, metastasis, survival , recurrence and laryngeal site of involvement. However,significantly correlated with T stage of hypopharyngeal and laryngeal squamous cell carcinoma, also correlated with prognosis of hypopharyngeal and laryngeal squamous cell carcinoma.The percentage of PCNA labeled cells showed the statistically significant with clinical and N stage, but no significance was found among other clinicopathological parameter and PCNA staining intensity.Conclusion:p21 WAF1/CIP1,PCNA play important roles in the progression of hypopharyngeal and laryngeal squamous cell carcinoma and are possible prognostic discriminators in hypopharyngeal and laryngeal squamous cell carcinoma.