nm23和E-cd蛋白在声门上喉癌中的表达与肿瘤转移及预后的关系

目的　研究nm2 3和E cd蛋白在声门上喉癌中的表达与肿瘤淋巴结转移及预后的关系。探讨肿瘤淋巴结转移的早期诊断方法。方法　应用免疫组化法观察 5 7例原发声门上喉癌组织中nm2 3基因蛋白和表皮钙粘素(E cd)的表达。结果　nm2 3和E cd蛋白表达与肿瘤淋巴结转移负相关。临床检查发现并经病理证实有淋巴结转移 (cN+ pN+ )组和临床查未发现但经病理证实有淋巴结转移 (cN-pN+ )组的nm2 3和E cd蛋白表达明显高于病理证实无淋巴结转移 (pN-)组。而cN+ pN+ 和cN-pN+ 组比较 ,nm2 3和E cd蛋白表达无显著差别。术后随访4 5例 ,nm2 3和E cd蛋白低表达组的 3年和 5年生存率均低于高表达组 ,差异具显著性 (P均 <0 .0 1)。结论　nm2 3和E cd蛋白表达可作为筛选有潜在淋巴结转移的临床N0 病例的重要指标 ;nm2 3和E cd蛋白的原位检测对声门上喉癌预后估计具有参考价值

Expression of nm23 and E-cd proteins in supraglottic carcinoma:relationship with tumor lymphatic metastasis and prognosis

Objective To study the expression of nm23 and E cd protein in supraglottic carcinoma and to explore the ways of early detecting lymphnode metastasis of tumors. Methods nm23 and E cd proteins were determined immunohistochemically in 57 cases of suproglottic squamous cell carcinomas, and the relationship between the expression, lymphnode metastasis, and prognosis were studied.Results In cN +pN + cases, the expression of nm23 and E cd proteins was lower than that of the pN - group. The difference was significant. Moreover, the significant reductions of nm23 and E cd proteins were found in carcinomas with occult metastases (cN -pN + cases); no difference was found between cN +pN + and cN -pN + groups. There was a strong postive correlation between worse prognosis and the lower expression of E cd protein. Conclusion The data suggest that the immunohistochemical determination of nm23 and E cd proteins in supraglottic larcinomas can be used as predictors of prognosis. The decreased expression of nm23 and E cd proteins in an important predictive sign of lymphnode metastasis. In addition, nm23 and E cd proteins could be useful in identifying patients with clinically negative lymphnodes who are at high risk for occult metastases.