Objective Purpose To explore the expressions of EBER, PCNA, Ki - 67 and C - myc gene protein and their significance on prognosis predicting for the patients with nasopharyngeal carcinomas. Method 20 cases of keratinizing squamous cell carcinoma and 40 cases of non - keratinizing carcinoma of the nasopharinx were collected for the experimental group , and 30 cases of nasopharyngeal chronic inflammation were collected for the control group. The molecular hybridization in situ was used for EBER detection, and immunohistochemical stain of two step method was used for PCNA, Ki - 67 and C -myc gene protein detection in each case of both groups. Result EBER was negative in all 30 cases of nasopharyngeal chronic inflammation (control group) and in all 20 cases of keratinizing squamous cell carcinoma, respectively (0/30 and 0/20). However, EBER was positive in all 40 cases of nasopharyngeal non - keratinizing carcinoma (40/40). Therefore, there is significant difference statistically between thenasopharyngeal chronic inflammation and keratinizing squamous carcinoma on one side and non-keratinizing carcinoma on the other side (P<0. 05). The positive rates of PCNA, Ki - 67 and C - myc were 67. 5% (27/40) , 65.7% (23/35) and 66. 6% ( 16/24) , respectively, in the patients of non - keratinizing carcinoma who are survived less than 5 years, and were 32. 5% (13/40) , 34. 2% (12/35) and 33. 3% (8/24) , respectively, in the patients of non - keratinizing carcinoma who were survived more than 5 years. Thus, the positive rates of those 3 markers are of a good correlation ( P < 0. 05) with the survival years more or less than 5 years in the patients of NKC. In addition, positive rates of PCNA, Ki -67 and C - myc were 60% (24/40) , 62. 8% (22/35) and 62. 5% (15/24) , respectively, in the patients of NKC with the remote metastasis, and were 40% (16/40) , 37. 1% (13/35) and 37. 5% (9/24) , respectively, in the patients of NKC without remote metastasis. It indicates there is a good correlation (P <0. 05) between the positive rates of those 3 markers and the presence or absence of remote metastasis in the patients of NKC. Conclusion The patients of NKC are almost always (100% ) with the infection of EB virus. The expressions of PCNA, Ki -67 and C - myc are wellassociated with the survival rate and prognosis of the patients with NKC.%目的 探讨EBV病毒、PCNA、Ki-67、C-myc癌基因蛋白在鼻咽癌中表达及预后意义.方法 收集鼻咽角化性鳞状细胞癌20例,鼻咽非角化性癌40例和对照组鼻咽粘膜慢性炎组织30例.用原位分子杂交方法检测EBV(EBER)病毒及采用免疫组织化二步法检测PCNA、Ki-67和C-myc癌基因蛋白的表达.结果 EBER在对照组鼻咽粘膜慢性炎30例及角化性癌鳞状细胞癌20例中均阴性0%(0/30,0/20);而EBER在鼻咽非角化性癌中阳性表达率100%(40/40);对照组和角化性鳞状细胞癌与非角化性癌比较差异有统计学意义(P<0.05).生存期<5年的40例鼻咽非角化性癌(NKC)组织中PCNA、Ki-67、C-myc分别为67.5%(27/40),65.7%(23/35),66.6%(16/24);生存期≥5年分别为32.5%(13/40)、34.2%(12/35)、33.3%(8/24).以上可见40例NKC患者中生存期<5年及≥5年的生存率有明显的相关性(P<0.05).除此之外,在40例非角化性癌组织中PCNA、Ki-67、C-myc癌基因阳性率在有远处转移的患者中分别为60%(24/40)、62.8%(22/35)、62.5%(15/24);在无远处器官转移的患者中分别为40%(16/40)、37.1%(13/35)、37.5%(9/24),显示与有无远处器官转移有明显的相关性(P<0.05).结论 鼻咽非角化性癌几乎100%有EBV病毒感染;PCNA、Ki-67、C-myc蛋白表达与鼻咽癌的生存率及预后密切相关.
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