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目的探讨病理学切缘和以p53、eIF4E为指标的分子切缘在预测喉癌患者预后中的价值。方法选择了253例喉癌患者进行病理学切缘研究，在以上病理学阴性切缘中选择67例，应用免疫组化方法检测p53、eIF4E蛋白的表达以进行分子切缘研究。结果1．病理学切缘、p53切缘、eIF4E切缘的阳性率分别是20．2％，19．4％和32．8％；2．阳性切缘患者的复发率高于切缘阴性者，包括病理学切缘(70．6％vs35．1％，P=0．0000)、p53切缘(69．2％vs33．3％，P=0．018)、eIF4E切缘(63．6％vs28．90A，P=0．018)；而切缘阳性者5年累积生存率低于切缘阴性者，包括病理学切缘(37．52％vs64．37％，P=0．0023)、p53切缘(24．62％vs75．69％，P=0．0012)、eIF4E切缘(43．31％vs77．52％，P=0．0006)。结论病理学切缘和以p53、eIF4E为指标的分子切缘阳性者的预后比切缘阴性者差，而p53和eIF4E可以从病理学切缘阴性者中发现预后更差的患者，并且eIF4E可能是优p53的分子指标。
Objective To investigate the value of pathologic margins and molecular cut-offs based on p53 and eIF4E in prognosis of patients with laryngeal cancer. Methods A total of 253 laryngeal cancer patients were selected for pathological resection. 67 cases were selected from the above pathologically negative margins. The expression of p53 and eIF4E protein was detected by immunohistochemistry to study the molecular excision. Results 1. The positive rates of pathology, p53 and eIF4E were 20.2%, 19.4% and 32.8%, respectively.2. The positive rate of recurrence was higher in patients with negative margins than in those with negative margins (70.6% vs35.1%, P = 0.0000), and p53 margin (69.2% vs33.3%, P = 0.018), eIF4E margin (63.6% vs28.90A, P = 0.018), while the 5-year cumulative survival rate of patients with positive margins was lower than that of negative margins, including pathological margins (37. 52% vs64.37%, P = 0.0023), p53 margin (24.62% vs75.69%, P = 0.0012), eIF4E margin (43.31% vs77.52%, P = .0006). Conclusions The prognosis of patients with positive pathologic margins and those with p53, eIF4E as an index are worse than those with negative margins, whereas p53 and eIF4E may be associated with worse prognosis in patients with pathologically negative margins, and eIF4E may It is the molecular index of excellent p53.