bcl-2、P 5 3基因及Epstein-Barr病毒在鼻咽癌中的表达

目的探讨鼻咽癌组织中p53、bcl-2、EBV表达情况及与主要临床指标间关系.方法免疫组化检测p53、bcl-2蛋白,多聚酶链反应(PCR)检测EBV.结果慢性炎性组织中p53、bcl-2及EBV阳性率分别为7.7%、23.1%和7.7%,明显低于鼻咽癌组织中的阳性率(分别为75.9%、88.9%和87.0%)(P<0.01).三者在鼻咽癌组织中共同阳性率为72.2%,p53、bcl-2明显正相关(r＝0.78,P<0.01).鼻咽癌伴颈淋巴结转移组p53阳性率(90.0%)明显高于无颈淋巴结转移组(58.3%)(P<0.01),临床Ⅱ、Ⅲ和Ⅳ期p53阳性率(分别为92.9%、78.9%和100%)均明显高于临床I期(38.5%)(P<0.01),且表达强度有增加的趋势.结论p53、bcl-2及EBV可作为鼻咽癌早期诊断的辅助指标之一,p53阳性的鼻咽癌患者较易发生颈淋巴结转移,随着鼻咽癌病程的发展,p53表达率及表达强度均增加,三者在鼻咽癌发生发展中起着重要作用.

Bcl-2, p53 expression and Epstein-Barr virus infection in primary nasopharyngeal carcinoma]

OBJECTIVE: To observe bcl-2, p53 gene expression and Epstein-Barr virus (EBV) infection and their relationship with clinicopathologic factors in primary nasopharyngeal carcinoma (NPC). METHOD: p53, bcl-2 proteins were assayed with immunohistochemical technique and EBV were assayed with polymerase chain reaction in 54 cases of NPC and 13 cases of chronic inflammation of nasopharyngeal epithelium (CINE). RESULT: The expression of p53, bcl-2 proteins and EBV were found respectively in 1(7.7%), 3(23.1%) and 1(7.7%) of 13 CINEs, which were significantly lower than those in 54 NPCs with respectively 41(75.9%), 48(88.9%) and 47(87%) (P < 0.01). In 39 cases of 54(72.2%) NPCs, we could find simultaneous p53, bcl-2 expression and EBV infection, furthermore, p53 and bcl-2 expression were significantly positively correlated with each other (r = 0.78, P < 0.01). p53 gene expression was significantly correlated with cervical lymph node metastasis of NPCs (P < 0.01). The expression of p53 in stage II, III, IV (92.9%, 78.9% and 100% respectively) were significantly higher than that in stage I (38.5%) (P < 0.01). CONCLUSION: The expression of p53, bcl-2 gene and EBV infection are the useful factors in the diagnosis of NPC, the overexpression of p53 is related with the stage and cervical lymph node metastasis of NPC, all the three play important roles in the pathogenesis of nasopharyngeal carcinoma.