nm23-H1基因在口腔鳞癌颈淋巴结转移不同阶段的调控作用

目的　探讨nm23-H1基因在口腔鳞癌区域淋巴结转移不同阶段的调控作用及影响。方法　利用免疫组化和Western Blot技术,结合淋巴结转移和原发灶浸润分型的资料,分组对照研究nm23-H1基因在200例口腔鳞癌颈淋巴结转移不同阶段的表达情况。结果　淋巴结转移组nm23-H1基因阴性表达率明显高于无淋巴结转移组(P<0·01)。N1期、转移仅累及1个淋巴结、Ⅳc型浸润,以及低分化肿瘤的患者,均有比其它患者明显增高的 nm23-H1基因的阴性表达率(P<0·01);转移至颌下或颌下-颈深上淋巴结平面者的阴性表达率,也高于转移到其它平面者(P<0·05)。结论　nm23-H1基因主要是通过干扰肿瘤实体内高转移细胞亚群的形成和初始转移的发生来调控口腔鳞癌患者的颈淋巴结转移。

The Regulation of nm23-H1/NDPK-A in Different Processes of Regional Lymph Node Metastases of Oral Squamous Cell Carcinomas

OBJECTIVE: To study the regulation and effect of the expression of nm23-H1 gene in different processes of regional lymph node metastases of oral squamous cell carcinomas(OSCC). METHODS: By immunohistochemical analysis in 200 paraffin-embedded tissues of OSCC and Western Blot in 9 fresh tissues of OSCC using a monoclonal antibody, the expression of nm23-H1/NDPK-A were detected in dividing groups accompanied with the clinical and pathological data of cervical lymph node metastases and modes of invasion. RESULTS: The rates of negative expression of nm23-H1/NDPK-A had significant differences between metastatic cases(34/81) and non-metastatic cases(15/119). The nm23-H1/NDPK-A negative group showed higher frequency of lymph node metasteses (P < 0.01). In the different metastatic processes, There were significantly differential expressions of nm23-H1/NDPK-A among stage N0, N1 and N2(P < 0.01), distinct involved quantities of lymph nodes (P < 0.01), dissimilar metastatic involved levels(P < 0.05), definite modes of invasion(P < 0.01) and different cell differentiations(P < 0.01). There were much higher negative expressions in those cases of N1 stage(23/38), only one lymph node to be involved(23/39), metastasized to submandibular nodes or/and superior deep cervical nodes(17/28 and 12/29, respectively), IV c types of invasion(33/54) and poor differentiations(9/19). CONCLUSION: The results indicated that nm23-H1/NDPK-A played an more important role in switching the initial metastases formation than in influencing the later metastases spread because the negative expressions of nm23-H1/NDPK-A in solid tumors of OSCC would induce the formation of high metastatic cellular subpopulations. It was also confirmed that nm23-H1 gene might be a metastatic suppressor and may be useful in predicting the initial lymph node metastases in OSCC.