鼻咽癌CT影像与增殖细胞核抗原表达的相关性研究

目的：探讨鼻咽癌（NPC）CT影像和增殖细胞核抗原（PCNA）的关系，深入认识CT征象的意义。资料与方法：搜集放疗前进行过CT检查的NPC活检标本69例（其中3年随访36例），采用免疫组织化学S－P法检测PCNA表达情况，详细分析NPC的CT表现为PCNA表达的关系。结果：（1）69例中，PCNA阳性率为94．3％（65／69），茎内软组织增厚致密PCNA高表达率（＞50％）为68．4％（26／38），而茎内软组织正常PCNA高表达率40．7％（11／27），两者有显著性差异（P＝0．026）；（2）当肿瘤累及后鼻孔鼻腔时，其PCNA高表达率较未受累者高（P＝0．04）；（3）当茎内软组织增厚致密时，其放疗后3年无瘤生存率低于茎内软组织正常者（P＝0．005）。结论：放疗前茎内软组织增厚致密者，PCNA多呈高表达，放疗后更易发生复发。

Study of the Correlation between CT Features and PCNA Expression in Nasopharyngeal Carcinoma

Objective To investigate the correlation between CT features and proliferating cell nuclear antigen (PCNA) in nasopharyngeal carcinoma (NPC), and to make a further understanding of CT signs.Materials and Methods Before radiotherapy, axial CT scanning was performed in 69 cases with NPC and their biopsy specimens were collected. Of 69 cases, 36 were followed for 3 years after radiotherapy. PCNA expression was examined by using S-P immunohistochemical technique in all cases. The correlation between CT findings and PCNA expression in NPC was analyzed in detail.Results (1) The PCNA positive rate was 94.3%. The rate of high expression of PCNA protein (>50%) in thickened and compacted soft-tissue medial to the styloid process was 68.4% (26/38), while it was 40.7% (11/27) in cases with normal soft-tissue medial to the styloid process. Significant difference existed between the two groups (P=0.026). (2) When the posterior naris and nasal cavity were involved, the rate of PCNA high expression became higher than that in cases with normal posterior naris and nasal cavity (P=0.04). (3) In cases with thickened and compacted soft-tissue medial to the styloid process, the free-of-tumor survival rate in three year after radiotherapy was lower than that in cases with normal soft-tissue medial to the styloid process (P=0.005).Conclusion In patients with thickened and compacted soft-tissue medial to the styloid process before radiotherapy, the PCNA expression is high in most cases, and a liability to recurrence after radiotherapy may be expected.