P53和P21蛋白在鼻咽癌中的表达及其临床意义

目的：探讨P53和P21蛋白在鼻咽癌（NPC）、癌旁组织和鼻咽慢性炎症中表达的差异，及其与肿瘤生物学行为的关系。材料与方法：首程放疗前的NPC病人100例，癌旁组织和鼻咽慢性炎症对照组各20例，用SP法进行P53和P21蛋白免疫组化染色，P53阳性细胞的标准为：癌巢内肿瘤细胞核有棕色沉着的细胞；P21阳性细胞的标准为：癌巢内肿瘤细胞浆有棕色沉着的细胞。结果：在鼻咽癌、癌旁组织和鼻咽慢性炎症组织中，P53蛋白的阳性率分别为：78．0％、35．0％和0．0％，P＝0．001；P21蛋白的阳性率分别为：83．0％、75．0％和65．0％，P＝0．170。在鼻咽癌原发灶早期（T1＋2）和晚期（T3＋4），颈结阴性和阳性及临床早期（Ⅰ Ⅱ）和临床晚期（Ⅲ Ⅳ）各组中，P53蛋白和P21蛋白的阳性率均无差异（P＞0．05）。结论：P53基因的突变与鼻咽癌的发生有一定的关系。P53蛋白可能是鼻咽癌癌病变的指标；P21的突变可能与鼻咽癌的发生无明显的关系，P53蛋白和P21蛋白的阳性率与鼻咽癌原发灶的早晚，颈结转移，和临床分期无关。

Clinical significance of p53 and p21 proteins expression in nasopharyngeal carcinoma(NPC)

Objective: To study the difference of p53 and p21 proteins expression in nasopharyngeal carcinoma(NPC) foci,paracarcinomatous tissue and chronic nasopharyngitis and the relation of their expression to NPC tumor biological behavior.Methods:Biopsy specimens of 100 NPC patients before initial radiotherapy course,20 of paracarcinomatous tissue and 20 of chronic nasopharyngitis patients were studied by means of SP immunohistochemical stain method for p53 and p21 proteins.Positive standard of p53 protein was that nuclei of NPC cells have brown deposit,and that of p21 protein was that cytoplasm of NPC cells have brown deposit.Results:In NPC foci,paracarcinomatous tissue and chronic nasopharyngitis,the positive rate of p53 protein was 78.0%?35.0% and 0.0%,respectively(P=0.001);and those of p21 protein was 83.0%?75.0% and 65.0%,respectively(P=0.17).Positive rates of p53 and p21 proteins were not statistically difference among NPC T,N,and clinical stages.Conclusion:There was an associations between p53 gene mutation and NPC,but no obvious associations for p21 gene mutation.P53 protein may be an indicator for precancerosis of NPC.Positive rates of p53 and p21 proteins did not obvious associate with NPC T,N,and clinical stages.