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目的 探讨Ⅲ期鼻咽分化型非角化性鳞癌中p5 3蛋白的表达与生物学行为及预后的关系 ,以及p5 3蛋白表达与p5 3基因突变和潜伏膜蛋白 (LMP) 1蛋白表达的关系。方法 应用免疫组织化学EnVison法和聚合酶链反应 单链构象多态性分析 (PCR SSCP)检测 5 8例Ⅲ期鼻咽分化型非角化性鳞癌标本。结果 5 8份Ⅲ期鼻咽分化型非角化性鳞癌中 ,p5 3蛋白总阳性率为 6 5 5 %(38/5 8) ,生存期在 5年以下的患者阳性率为 82 .1%(32 /39) ,5年以上患者 31.6 %(6 /19) ,两组间p5 3蛋白表达差异有显著性意义 (P <0 .0 5 ) ;p5 3蛋白表达在有颅底侵袭组为 74.4%(2 9/39) ,无颅底侵袭组为47 4 %(9/19) ,两组间差异有显著性意义 (P <0 .0 5 )。PCR SSCP检测 15例p5 3蛋白阳性的病例 ,p5 3基因 5～ 8外显子突变率为 0 (0 /15 )。LMP 1蛋白免疫组织化学总阳性率为 72 .4%(4 2 /5 8) ,与p5 3蛋白表达呈正相关关系 (r=0 .5 0 4)。结论 本组Ⅲ期鼻咽分化型非角化性鳞癌患者中p5 3蛋白表达与p5 3基因突变无相关关系 ,与LMP 1蛋白的表达相关。p5 3蛋白的表达阳性率随着患者生存期的延长而降低 ,有颅底侵袭组p5 3蛋白表达阳性率高于无颅底侵袭组。
Objective To investigate the relationship between the expression of p5 3 protein and the biological behavior and prognosis in stage Ⅲ nasopharyngeal non-keratinizing squamous cell carcinoma and the relationship between the expression of p5 3 protein and the mutation of p5 3 gene and the expression of latent membrane protein (LMP) 1 relationship. Methods Fifty-eight cases of stage Ⅲ nasopharyngeal non-keratinizing squamous cell carcinoma were detected by immunohistochemistry EnVison and polymerase chain reaction single strand conformation polymorphism (PCR SSCP). Results The positive rate of p5-3 protein in 58 patients with stage Ⅲ nasopharyngeal non-keratinizing squamous cell carcinoma was 65.5% (38/5 8). The positive rate of p5 3 protein in patients with survival stage of less than 5 years was 82.1 % (32/39), and 31.6% (6/19) in patients over 5 years. There was significant difference between the two groups in the expression of p5 3 protein (P <0.05). The expression of p53 protein in patients with skull base invasion , 74.4% (29/39) and 47.4% (9/19), respectively. There was a significant difference between the two groups (P <0.05). Fifteen cases with positive p5 3 protein were detected by PCR SSCP. The mutation rate of exon 5 to 8 of p5 3 gene was 0 (0/15). The positive rate of LMP 1 protein immunohistochemistry was 72.4% (4 2/5 58), which was positively correlated with the expression of p5 3 protein (r = 0.540). Conclusion There is no correlation between the expression of p5 3 protein and the mutation of p5 3 gene in stage Ⅲ nasopharyngeal non-keratinizing squamous cell carcinoma, which correlates with the expression of LMP 1 protein. The positive rate of p5-3 protein expression decreased with the prolongation of survival time. The positive rate of p5 3 protein expression in the basal invasion group was higher than that in the non-skull base invasion group.