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目的探讨鼻咽癌经颅底自然通道脑膜侵犯的MRI表现及其与p53蛋白表达的关系。方法搜集经颅底自然通道侵犯脑膜的初诊鼻咽癌患者41例,无颅底自然通道及脑膜受累鼻咽癌患者47例作为对照组,用S-P法检测两组患者p53蛋白的表达情况,分析MRI表现与p53蛋白表达的关系。结果鼻咽癌脑膜侵犯患者中经卵圆孔有21例,经破裂孔有16例,经圆孔有4例。经颅底自然通道脑膜侵犯组p53蛋白的阳性表达率为87.8%(36/41),对照组p53蛋白的阳性表达率为70.2%(33/47),两者之间差异有统计学意义(P<0.05)。结论卵圆孔是鼻咽癌经颅底自然通道脑膜侵犯的主要途径,经颅底通道脑膜侵犯的患者有较高的p53蛋白阳性表达率,对临床方案的制定及预后判断有一定指导意义。
Objective To investigate the MRI findings and the relationship with the expression of p53 protein in the nasal cutaneous natural passage of nasopharyngeal carcinoma. Methods 41 patients with newly diagnosed nasopharyngeal carcinoma who had penetrated the meninges through the natural passage of the skull base and 47 patients with nasopharyngeal carcinoma without cranial base and 47 patients with meningeal involvement were used as the control group. The expression of p53 protein in both groups was detected by SP method. MRI findings and p53 protein expression. Results In patients with nasopharyngeal carcinoma involving meninges, there were 21 cases with oval foramen, 16 cases with ruptured holes and 4 cases with circular holes. The positive expression rate of p53 protein in the transmembrane of natural passage in the skull base was 87.8% (36/41), while the positive expression rate of p53 protein in the control group was 70.2% (33/47), the difference was statistically significant P <0.05). Conclusions The foramen ovale is the main way of invasion of meninges of nasopharyngeal carcinoma through the natural passage of skull base. The high expression rate of p53 protein in patients with transmembranous meningeal invasion of the skull base has some guiding significance in the formulation and prognosis of clinical programs.