c-myc、P21^WAF1和LMP-1在鼻咽癌中表达的意义及其与Ki67的关系木

目的：研究原癌基因c-myc、细胞周期凋控蛋白（P21^WAF1）、EB病毒潜伏膜蛋白1（Latent membrane protein 1）LMP-1与Ki67在鼻咽癌（Nasopharyngeal carcinoma，NPC）中的表达及其相关性和临床意义。方法：应用免疫组织化学Envision二步法检测35例经治疗后，生存时间〈5年的鼻咽非角化性癌（Nonkeratinizing carcinoma，NKC），60例生存时间≥5年的NKC及对照组30例鼻咽黏膜慢性炎症组织（non—tumour nasopharyngeal tissue，NP）内c-myc，P21^WAF1，LMP-1，Ki67的表达水平。结果：（1）c-myc，LMP-1和Ki67在生存时间〈5年组、生存时间≥5年组及NP组中的阳性表达率依次递减（P〈0．05）；（2）P21^WAF1在NKC生存时间〈5年组，生存时间〉15年组及NP组中的阳性率依次递增（P〈0．05）；（3）c—myc的阳性表达与NKC的淋巴结转移有关（P〈0．05）。LMP-1，Ki67的阳性表达与NKC临床分期密切相关（P〈0．05）；（4）c—myc和LMP-1共同表达时较两者各自单独表达时，Ki67的强表达率明显增强；（5）c—myc和LMP-1的阳性表达与Ki67的强表达呈正相关关系，P21^WAF1的阳性表达与Ki67的强表达呈负相关关系。结论：c—myc，LMP-1的高表达及P21^WAF1的低表达与NPC细胞的增殖密切相关，且前两者在NKC发生发展中存在协同作用；通过检测c—myc，P21^WAF1，LMP-1及Ki67的表达，有助于对NKC预后的评估。

The Significance of the Expression of c-myc, P21^WAF1, LMP-1 and Its Relationship with the Expression of Ki67 in Nesopharyngeal Carcinoma

Objective: To investigate the correlation between the expression of c-myc,P21~(WAF1),LMP-1 and Ki67 and its clinical significance in nasopharyngeal carcinoma(NPC).Methods: The Envision Immunohistochemical method was applied to detect the expression of c-myc,P21~(WAF1),LMP-1 and Ki67 in 35 cases of nonkeratinizing carcinoma(NKC) survived less than 5 years(group 1),60 cases of NKC survived over 5 years(group 2) and 30 cases of non-tumor nasopharyngeal tissue(group 3).Results: 1) The positive expression rates of c-myc,LMP-1 and Ki67 were significantly difference between group 1 and group 2,and between group 2 and group 3(P<0.05).2) The positive expression rates of P21~(WAF1) were significantly different among group 1,group 2 and group 3(P<0.05).3) The positive expression rates of c-myc were much higher in lymph node metastasis cases compared with those without lymph node metastasis;and the positive expression rates of LMP-1 and Ki67 correlated with the disease clinical staging.4) The overexpression of Ki67 was stronger with combined expression of c-myc and LMP-1 than with the individual expression of them.5) The positive expression of of c-myc,LMP-1 positively correlated with the expression and Ki67,and there was a negative correlation between the expression of P21~(WAF1) and Ki67.Conclusions: High expression of c-myc,LMP-1 and low expression of P21~(WAF1) may play important roles in carcinogensis of NKC.They have some relationships to proliferative activity of nonkeratizing carcinoma cells.The results suggest that immunological labeling of c-myc,P21~(WAF1),LMP-1 and Ki67 might be useful for the determination of NKC prognosis.