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目的:探讨头颈鳞癌手术切缘p53表达及其与肿瘤局部复发和预后的关系。方法:用免疫组织化学的方法检测82例头颈鳞癌患者手术切缘中p53的表达情况,并分析其与肿瘤局部复发,临床病理学参数和预后之间的关系。结果:在82例头颈鳞癌患者中,切缘塞变型p53阳性表达率为59.76%(49/82)。阳性表达主要定位于切缘上皮细胞核。p53蛋白在头颈鳞癌手术切缘中的表达显著高于其在正常口腔粘膜组织中的表达(x2=10.497,P<0.05)。头颈鳞癌患者手术切缘p53的表达与肿瘤分化程度(x2:12.332,P<0.01)和局部复发显著相关(x2=5.425,P<0.05),但与患者年龄、性别、肿瘤病理分期以及淋巴结转移无关(P>0.05)。切缘p53表达阴性组较阳性组术后可能有较好的预后(x2=3.559,P=0.059)。结论:切缘p53的阳性表达与头颈鳞癌术后肿瘤的进展有关,它有望成为指导头颈鳞癌治疗和判断预后的一项重要指标。
Objective: To investigate the expression of p53 in the margins of surgical head and neck squamous cell carcinoma and its relationship with local recurrence and prognosis. Methods: The expression of p53 in the surgical margins of 82 patients with squamous cell carcinoma of head and neck was detected by immunohistochemistry. The relationship between the expression of p53 and tumor recurrence, clinicopathological parameters and prognosis was analyzed. Results: In the 82 cases of squamous cell carcinoma of the head and neck, the positive rate of p53 in the marginal plug was 59.76% (49/82). The positive expression mainly located in the marginal epithelial cell nucleus. The expression of p53 protein in the surgical margins of squamous cell carcinoma of head and neck was significantly higher than that in normal oral mucosa tissues (x2 = 10.497, P <0.05). The expression of p53 at the surgical margin of patients with head and neck squamous cell carcinoma was significantly associated with the degree of tumor differentiation (x2: 12.332, P <0.01) and local recurrence (x2 = 5.425, P <0.05), but not with the age, sex, tumor stage and lymph node No correlation with metastasis (P> 0.05). The margin of p53 expression negative group than the positive group may have a better prognosis (x2 = 3.559, P = 0.059). Conclusion: The positive expression of p53 at the margin is related to the progress of postoperative tumor in head and neck squamous cell carcinoma. It is expected to be an important index to guide the treatment and prognosis of head and neck squamous cell carcinoma.