喉组织中相关特异性蛋白异常的表达及临床意义

摘要

目的 探讨喉组织中相关特异性蛋白异常的表达及其临床意义.方法 所有病理标本来源于2012年5月至2015年2月间我院耳鼻咽喉头颈外科因喉部不同病因需要接受手术治疗住院患者,其中,喉癌组织标本(喉癌组)、喉声带息肉组织标本(息肉组)和喉癌前病变组织标本(癌前组)各69例.喉癌标本按照2010年国际抗癌联盟(UICC)标准进行临床分期和病理分级.采用过氧化物酶标记链酶卵蛋白素染色法检测各组标本中人乳头状瘤病毒16E7蛋白(HPV16E7)和细胞周期调节蛋白D1(Cyclin D1)表达水平.采用相关统计学分析和比较各组间HPV16E7和Cyclin D1阳性表达率和相关性差异.结果 喉癌组HPV16E7和Cyclin D1阳性表达出现于细胞核,为大量黄褐色粗大颗粒,阳性表达率分别为44.93%和52.17%,明显强于息肉组(分别为2.90%和8.70%)和癌前组(分别为5.80%和23.19%),差异均有显著统计学意义(P<0.01),癌前组HPV16E7和Cyclin D1阳性表达率较息肉组也明显提高,差异均有统计学意义(P<0.05);在喉癌临床分期中,HPV16E7和Cyclin D1阳性表达率在Ⅰ~Ⅳ期中随着分期增加呈上升趋势(P<0.01);在喉癌病理分级中,HPV16E7和Cyclin D1阳性表达率随分化程度减弱,均表现为Ⅲ级>Ⅱ级>Ⅰ级(P<0.01);HPV16E7和Cyclin D1阳性表达率与喉癌发生率均具有显著正相关(r=0.79、0.86,P=0.003,0.002),两者相互间阳性表达率也呈显著正相关(r=0.68,P=0.005).结论 喉癌的发生和发展与HPV16E7和Cyclin D1过度表达密切相关,因此,对HPV16E7和Cyclin D1检测有利于提高患者的临床早期诊断和生存预后.%Objective To investigate the effects and clinical significances of abnormal expressions of human papillomavirus 16E7 protein (HPV16E7) and cell cycle protein D1 (Cyclin D1) on patients with laryngeal squamous cell carcinoma. Methods All the pathologic specimens were collected from the patients with laryngeal diseases who under-went surgical treatment because of different causes in Department of Otolaryngology of our hospital from May 2012 to February 2015, which included laryngeal squamous cell carcinoma (LSC group) and vocal cord polyp (VCP group) as well as laryngeal precarcinoma lesions (LPL group), with 69 cases in each group. According to the correlated standard of 2010 International Anti-Cancer Association, the clinical stage and pathological degree were further developed in the spec-imens of LSC group. The expression levels and clinical pathological features of HPV16E7 and Cyclin D1 were detected through the immunohistochemical SP staining methods. Moreover, the positive expression rate and correlational differ-ence were analyzed and compared by statistical software in the three groups. Results The positive expressions of HPV16E7 and Cyclin D1 were observed in cell nucleus in LSC group, which got a great number of thick and brown par-ticles. Compared with VCP and LPL groups, the positive expression rate of HPV16E7 and Cyclin D1 were significantly increased in LSC group (44.93%vs 2.90%and 5.80%, 52.17%vs 8.70%and 23.19%, respectively), P<0.01. Compared with VCP group, the positive expression rate of HPV16E7 and Cyclin D1 in LPV group were significantly increased (P<0.05). The positive expression rate of HPV16E7 and Cyclin D1 were increasingly grown up from stageⅠto stageⅣ, and raised with degreeⅢ>degreeⅡ>degreeⅠin LSC group (P<0.01, respectively). The positive expression rate of the two proteins had significant positive correlation with the incidence of LSC (r=0.79, 0.86, P=0.003, 0.002), and positive expres-sion rate of HPV16E7 had also completed positive correlation with that of Cyclin D1 in LSC group (r=0.68, P=0.005). Conclusion The occurrence and development of laryngeal carcinoma might have the significant relationship with HPV16E7 and Cyclin D1 in patients with LSC. To detect HPV16E7 and Cyclin D1 in laryngeal organization of patients might contribute to enhancement of early diagnosis and prognosis of survival of laryngeal carcinoma patients in clinic.