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目的 :探讨喉鳞癌 (LSCC)癌变过程中P53和Bcl- 2表达的临床病理意义。方法 :用免疫组化S -P技术检测 2 0例喉正常粘膜 (LNM)、38例喉粘膜不典型增生 (LAH)和 50例LSCC中P53和Bcl- 2的表达情况。结果 :P53蛋白阳性染色局限于细胞核 ,Bcl- 2阳性表达定位于细胞浆。在LNM、LAH和LSCC中 ,P53阳性表达率分别为 0 0 % (0 / 2 0 )、52 6 % (2 0 / 38)和 62 0 % (31 / 50 ) ,组间比较有统计学意义 (χ2 =2 2 72 2 P =0 0 0 1 ) ;Bcl- 2阳性表达率分别为 5 0 % (1 / 2 0 )、76 3 % (2 9/ 38)和 50 0 %(2 5/ 50 ) ,组间比较亦有统计学意义 (χ2 =2 6 698 P =0 0 0 1 )。Bcl- 2在Ⅰ、Ⅱ、Ⅲ级LSCC中阳性表达率分别为 1 1 1 % (1 / 9)、44 0 % (1 1 / 2 5)和 81 3 % (1 3/ 1 6) ,组间比较有统计学意义 (χ2 =1 2 0 54 P=0 0 0 2 ) ;在有淋巴结转移组和无淋巴结转移组表达率分别为 66 7% (1 8/ 2 7)和 30 4% (7/ 2 3) ,组间比较亦有统计学意义 (χ2 =6 52 2 P =0 0 1 1 ) ,而P53与LSCC病理分级和淋巴结转移无关 (P >0 0 5)。在LAH和LSCC两组中 ,P53和Bcl- 2之间均呈负相关 (P <0 0 5)。结论 :P53和Bcl- 2异常表达是LSCC发生过程中的早期事件。Bcl- 2基因过表达与LSCC病理分级和淋巴结转移密切相关
Objective: To investigate the clinicopathological significance of P53 and Bcl-2 expression in carcinogenesis of laryngeal squamous cell carcinoma (LSCC). Methods: The expression of P53 and Bcl-2 in 20 cases of laryngeal mucosa (LNM), 38 cases of laryngeal mucosa dysplasia (LAH) and 50 cases of LSCC were detected by immunohistochemical S-P technique. Results: The positive staining of P53 protein was localized in the nucleus and the positive expression of Bcl-2 was localized in the cytoplasm. The positive rates of P53 in LNM, LAH and LSCC were 0 0% (0/20), 52 6% (2 0/38), and 62 0% (31/50), respectively, with statistically significant differences (χ2 = 2 2 72 2 P = 0 0 0 1). The positive rate of Bcl-2 expression was 50% (1/2 0), 76 3% (2 9/38) and 50 0% 50). There was also a statistically significant difference between groups (χ2 = 2 6 698 P = 0 0 0 1). The positive rates of Bcl-2 in grade Ⅰ, Ⅱ, and Ⅲ LSCC were 1 1 1% (1/9), 44 0% (1 1/2 5) and 81 3% (1 3/1 6) (Χ2 = 1 2 0 54 P = 0 0 0 2). The positive expression rates in the group of lymph node metastasis and non-lymph node metastasis were 66 7% (18/27) and 30 4% There was no significant difference between the two groups (χ2 = 6 522 P = 0 0 1 1). However, P53 was not associated with pathological grade and lymph node metastasis (P> 0.05). In both LAH and LSCC groups, there was a negative correlation between P53 and Bcl-2 (P <0.05). Conclusion: Abnormal expression of P53 and Bcl-2 is an early event in the development of LSCC. The overexpression of Bcl-2 is closely related to the pathological grade of LSCC and lymph node metastasis