上颌窦恶性肿瘤组织中p53和PCNA的表达及其意义

背景与目的：据文献报道,p53和增殖细胞核抗原（proliferating cell nuclear antigen,PCNA)与恶性肿瘤的发生发展有密切关系,本研究检测p53和PCNA在上颌窦恶性肿瘤、良性肿瘤和炎症性病变中表达的强度差异,探讨p53和PCNA与上颌窦恶性肿瘤临床分期、病理分型及淋巴结转移的关系。方法：用免疫组化的方法检测108例上颌窦恶性肿瘤、19例上颌窦良性肿瘤、8例鼻粘膜炎症中p53与PCNA的表达情况。数据统计采用秩和检验,并用平均秩衡量p53和PCNA的阳性表达强度。结果：在上颌窦良性肿瘤和鼻粘膜炎症两组中,p53和PCNA的平均秩分别为42．8、50．3和47．9、46．8;在恶性肿瘤组中,p53和PCNA平均秩分别高达73．0和73．2;在上颌窦恶性肿瘤中,鳞癌p53的平均秩为60．7,比腺癌的平均秩（43．9）高,有显著性差异（P＜0．05）。但临床分期I－Ⅳ期中,p53平均秩分别为46．6、50．1、56．1、55．0,PCNA平均秩分别为60．5、48．8、56．1、53．9;在无淋巴结转移组和有淋巴结转移组中,p53平均秩分别为53．7和57．3,PCNA平均秩分别为53．9和56．4;在生存期＜3年、＜5年和≥5年等3组中,p53平均秩分别为49．9、53．7和48．5,PCNA平均秩分别为45．7、56．9和52．0,均无显著性差异（P＞0．05）。结论：p53和PCNA与上颌窦恶性肿瘤尤其是鳞癌的发生、发展有一定相关性,而与上颌窦恶性肿瘤的临床分型、淋巴结转移和预后无关。

Expression and significance of p53 and proliferating cell nuclear antigen in malignant tumor of maxillary sinus

BACKGROUND & OBJECTIVE: p53 and proliferating cell nuclear antigen (PCNA) play an important role in the development of malignant tumor. This study was designed to evaluate the role of p53 and PCNA in the development of malignant tumor of maxillary sinus by detecting their expression in malignant, benign, and inflammatory lesions of maxillary sinus. METHODS: The expressions of p53 and PCNA were detected by immunohistochemistry in 108 malignant, 19 benign, and 8 inflammatory tissues of maxillary sinus. Rank sum test was used and the levels of positive degree of p53 and PCNA were represented by mean rank. RESULTS: The mean ranks of p53 and PCNA were 42.8 and 47.9 in inflammatory group and 50.3 and 46.8 in benign group, but 73.0 and 73.2 in malignant group, respectively. In malignant group, mean rank of p53 in squamous cell carcinoma (SCC) was 60.7, which was higher than that in adenocarcinoma (43.9). The differences were significant (P < 0.05). While from stage I to stage IV, the mean ranks of p53 were 46.6, 50.1, 56.1, and 55.0 and the mean ranks of PCNA were 60.5, 48.8, 56.1, and.