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目的:从分子水平判定喉鳞状细胞癌(LSCC)切除范围的彻底性及与预后的关系。方法:用免疫组织化学方法检测23例LSCC患者手术切缘组织中癌基因EGFR和抑癌基因p53、p27以及与凋亡有关的Bcl-2蛋白的表达情况,并通过随访观察其与肿瘤复发的关系。结果:23例LSCC患者中20例手术切缘组织细胞病理检测为阴性,其中p53阳性3例(15%),p27阳性11例(55%),Bcl-2阳性7例(35%),EGFR阳性3例(15%)。有4例肿瘤局部复发,其p27均为阴性;2例Bcl-2阳性;p53和EGFR均为阴性。结论:用免疫组织化学方法检测LSCC手术切缘EGFR、p53、p27、Bcl-2水平来判断手术范围是可行的,其中p27蛋白表达较为重要,但应同时检测多种基因。
Objective: To determine the thoroughness of resection of laryngeal squamous cell carcinoma (LSCC) and its relationship with prognosis at the molecular level. Methods: The expressions of oncogene EGFR, tumor suppressor genes p53, p27 and apoptosis-related Bcl-2 protein in 23 cases of LSCC were detected by immunohistochemical method and observed with the recurrence of tumor relationship. RESULTS: Twenty cases of LSCC were negative in the pathological examination of the margins of the resected LSCCs, including p53 positive in 3 cases (15%), p27 positive in 11 cases (55%), Bcl-2 positive in 7 cases (35%), EGFR Positive in 3 cases (15%). There were 4 cases of local tumor recurrence, the p27 were negative; 2 cases of Bcl-2 positive; p53 and EGFR were negative. CONCLUSION: It is feasible to determine the surgical range by immunohistochemical staining of EGFR, p53, p27 and Bcl-2 in the margins of LSCC. Among them, p27 protein expression is more important, but multiple genes should be detected simultaneously.