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目的 利用p5 3蛋白、p16蛋白及增殖细胞核抗原 (PCNA)在口腔粘膜白斑 (OralLeukoplakia ,OLK)中的表达 ,评估OLK的恶变潜能。方法 免疫组化技术。结果 正常口腔粘膜p5 3蛋白表达阴性 ,p16、PCNA表达阳性。口腔不典型增生性白斑 (dysplasialeukoplakia ,DLK)p5 3阳性表达率 (5 8 16 % )显著高于单纯增生性白斑 (simplehyperplasialeukoplakia ,SHLK) (12 5 0 % ,P <0 0 5 )。口腔DLK与口腔鳞癌组间p5 3蛋白阳性指数差异有显著性 (P <0 0 5 )。PCNA在口腔DLK中表达分布主要为基底上层模式 ,与正常口腔粘膜及SHLK的基底层分布模式间差异有显著性 (P <0 0 1) ,其PCNA表达阳性指数显著较SHLK为高 (P <0 0 1)。结论 p5 3蛋白表达在OLK由单纯增生向不典型增生转化过程中起主要作用。PCNA阳性指数能较好的反映口腔粘膜病变的增殖水平。PCNA基底上层表达模式能较好反映口腔粘膜白斑的不典型增生。通过对这些基因产物检测 ,可评价OLK的恶变潜能 ,筛选高危白斑 ,为临床治疗提供依据。
Objective To evaluate the malignant potential of OLK using the expression of p53 protein, p16 protein and proliferating cell nuclear antigen (PCNA) in oral mucosal leukoplakia (oral leukoplakia, OLK). Methods Immunohistochemistry. Results The expression of p53 protein in normal oral mucosa was negative, and the expression of p16 and PCNA was positive. The positive expression rate of p53 in dysplasial eukoplakia (DLK) was significantly higher than that of simple hyperplasia (p < 0.05). There was a significant difference in the positive index of p53 protein between oral DLK and oral squamous cell carcinoma (P < 0.05). The expression distribution of PCNA in oral DLK was mainly basal upper layer pattern, which was significantly different from that of normal oral mucosa and basal layer distribution pattern of SHLK (P < 0.01), and the PCNA expression positive index was significantly higher than SHLK (P < 0 0 1). Conclusion The expression of p53 protein plays a major role in the transformation of OLK from dysplasia to atypical hyperplasia. PCNA positive index can better reflect the proliferation of oral mucosal lesions. PCNA basal expression pattern can better reflect the dysplasia of oral leukoplakia. By detecting these gene products, the malignant potential of OLK can be evaluated and high-risk leukoplakia can be screened to provide a basis for clinical treatment.