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目的 :探讨喉癌、喉癌前病变、喉良性病变增殖细胞核抗原 ( PCNA)表达的临床意义。方法 :免疫组织化学染色 ,图像分析仪定量检测 PCNA的表达。结果 :PCNA表达在喉癌不同病理分级之间增殖指数 ( PI)值及阳性单位 ( PU)值比较差异均有显著性 ( P<0 .0 1 ) ,随病理上恶性度的增高 ,PCNA表达量增加。喉鳞癌 I级、喉粘膜重度不典型增生、喉粘膜白斑的 PI、PU值均明显高于正常喉粘膜 ( P<0 .0 1 ) ,但这三者之间差异无显著性 ( P>0 .0 5)。 PCNA的表达量与喉鳞癌临床 N分期呈正相关 ,而与 T分期无关。PU值与病人的生存时间呈负相关 ( P<0 .0 1 )。声带息肉部分病人 PCNA有阳性表达。结论 :喉粘膜重度不典型增生、喉粘膜白斑病变具有高度恶变潜能。过量表达 PCNA的喉鳞癌病例细胞增殖能力强、分化差 ,易向颈淋巴结转移 ,预后不良。对 PCNA的检测临床上可作为喉癌早期诊断及评估预后的良好指标。
Objective: To investigate the clinical significance of the expression of proliferating cell nuclear antigen (PCNA) in laryngeal carcinoma, laryngeal precancerous lesions and benign larynx lesions. Methods: Immunohistochemical staining and image analyzer were used to detect the expression of PCNA. Results: There were significant differences in proliferating index (PI) value and positive unit (PU) value between different pathological grades of PCNA (P <0.01). The PCNA expression was increased with the increase of pathological grade Increase in volume. The grade I of laryngeal squamous cell carcinoma, the severe atypical hyperplasia of laryngeal mucosa and the PI and PU of laryngeal mucosa were significantly higher than those of normal laryngeal mucosa (P <0.01), but there was no significant difference between the three (P> 0 .0 5). The expression of PCNA was positively correlated with clinical stage of laryngeal squamous cell carcinoma, but not with T stage. PU value was negatively correlated with patient’s survival time (P <0.01). Vocal cord polyp in some patients with PCNA positive expression. Conclusion: The severe dysplasia of laryngeal mucosa and laryngeal leukoplakia have high malignant potential. The cases of laryngeal squamous cell carcinoma that overexpressed PCNA had strong proliferative ability, poor differentiation, easy metastasis to cervical lymph node and poor prognosis. The detection of PCNA clinically as early diagnosis of laryngeal cancer and assess the prognosis of a good indicator.