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目的 :探讨癌基因c myc、bcl 2蛋白产物在上颌窦癌中的表达情况及其临床意义。方法 :采用免疫组织化学方法 ,对 4 6例上颌窦癌及 5 6例正常鼻粘膜组织中癌基因c myc、bcl 2蛋白产物进行检测。 结果 :正常鼻粘膜鳞状上皮细胞中癌基因c myc、bcl 2蛋白阳性率为 0 ;上颌窦癌细胞中 ,癌基因c myc、bcl 2蛋白阳性率分别为 73.91% (34/46 )、6 0 .87% (2 8/46 )。复发组c myc蛋白的阳性率 (91.6 7% )显著高于未复发组 (6 7.6 5 % ) ,P<0 .0 1;复发组bcl 2蛋白的阳性率 (5 0 .0 % )明显低于未复发组 (6 4 .71% ) ,P <0 .0 5。c myc蛋白阳性率随临床分期的增加而升高 ,其中Ⅳ期阳性率 (88.89% )明显高于Ⅱ期 (6 3.6 4 % ) ,P <0 .0 5 ;bcl 2蛋白阳性率随临床分期的增加而下降 ,Ⅳ期阳性率 (5 5 .5 6 % )明显低于Ⅱ期 (72 .73% ) ,P <0 .0 5。bcl 2蛋白的阳性率随原发癌病理分级的降低而下降 ,低分化组 (5 6 .2 5 % )明显低于高分化组 (71.4 3% )和中分化组 (6 2 .5 0 % ) ,P <0 .0 1和 0 .0 5 ;中分化组 (6 2 .5 0 % )亦明显低于高分化组 (71.4 3% ) ,P <0 .0 5 ;p6 2 c myc的阳性率与原发癌病理分级无明显关系。结论 :c myc、bcl 2基因参与了上颌窦的癌变及发展过程 ,其表达水平是判断病情及预测复发的敏感基因
Objective: To investigate the expression of oncogene c-myc and bcl-2 protein in maxillary sinus cancer and its clinical significance. Methods: Immunohistochemistry was used to detect the c-myc and bcl-2 protein in 46 cases of maxillary sinus cancer and 56 cases of normal nasal mucosa. Results: The positive rates of c-myc and bcl-2 protein in normal nasal squamous cell were 0. The positive rates of c-myc and bcl-2 protein in maxillary sinus cancer were 73.91% (34/46), 6 0.87% (2 8/46). The positive rate of c-myc protein in recurrence group (91.6 7%) was significantly higher than that in non-recurrence group (6.6 7.6%), P <0.01; the positive rate of bcl-2 protein in recurrence group was significantly lower In the non-recurrent group (64.71%), P <0.05. The positive rate of c-myc protein increased with the clinical stage, of which the positive rate of stage Ⅳ (88.89%) was significantly higher than that of stage Ⅱ (6 3.6%), P <0.05. The positive rate of bcl- (P <0.05), the positive rate of stage Ⅳ (55.56%) was significantly lower than that of stage Ⅱ (72.73%), P <0.05. The positive rate of bcl-2 protein decreased with the pathological grade of primary cancer, while it was significantly lower in poorly differentiated group (65.25%) than in well-differentiated group (71.4%) and moderately differentiated group (62.0% ), P <0. 01 and 0. 05; the moderately differentiated group (62.5%) was also significantly lower than the well-differentiated group (71.4 3%), P <0. Positive rate and primary cancer pathological grade no significant relationship. Conclusion: The expression of c-myc and bcl-2 is involved in the carcinogenesis and progression of the maxillary sinus. The expression level of c-myc and bcl-2 is a sensitive gene to judge the prognosis of the maxillary sinus