p53蛋白表达与上颌窦鳞状细胞癌发生的关系

用免疫组化技术对８例上颌窦正常粘膜、１６例乳头状瘤及癌变、５０例鳞状细胞癌及１４例癌旁粘膜（包括癌旁正常粘膜、单纯增生及不典型增生）ｐ５３蛋白的表达进行了检测。结果显示，上颌窦癌ｐ５３阳性率为６２％（３１／５０）。ｐ５３表达与患者性别、年龄及肿瘤分化程度无关。上颌窦正常粘膜、单纯增生及乳头状瘤ｐ５３表达阴性。不典型增生ｐ５３表达为４／６，其表达与相应鳞癌存在一致性，不典型增生ｐ５３阳性者，相应癌组织亦为阳性，反之亦然。４例乳头状瘤癌变中，３例ｐ５３阳性。研究结果表明，ｐ５３表达是人上颌窦癌发生的早期事件，而与其恶性程度无关，ｐ５３表达发生于不典型增生或乳头状瘤癌变阶段，显示ｐ５３基因突变与上颌窦癌的发生密切相关。研究结果还表明，检测ｐ５３蛋白有助于上颌窦良，恶性病变的鉴别及早期发现上颌窦癌。

Relationship between p53 protein expression and development of squamous cell carcinoma of maxillary sinus

The expressions of p53 protein were immunohistochemically studied in 8 normal epithelia,16 papillomas and papillomas with malignant change,50 squamous cell carcinomas and 14 epithelia adjacent to carcinomas including normal epithelia,simple hyperplasias and dysplasias of the maxillary sinus.The results showed that the frequency of p53 expression in maxillary sinus carcinoma was 62%(31/50),and there was no significant correlation between p53 expression and patient's sex,age or differentiation of tumor.p53 expression was observed not in normal epithelia,simple hyperplasias and papillomas but in 4 out of 6 dysplasias.p53 expressions in dysplasias were accorded with those in squamous cell carcinomas,i.e,in the p53-positive cases of dysplasia,and the corresponding carcinomas were also positively p53-expressed and vice versa.Three out of 4 papillomas with malignant change were positive for p53 expression.These suggested that p53 expression would be an early event in the development of maxillary sinus carcinoma and not correlate with its malignant degree.The evidence that p53 expression appeared in the stages of dysplasia and papilloma's malignant change showed that the p53 gene mutation might play an important role in the carcinogenesis of epithelia in maxillary sinus.The study also indicates that the detection of p53 protein might be useful in distinguishing benign and malignant lesions of the maxillary sinus and discovering early maxillary sinus carcinoma.