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目的探讨鼻咽癌 T 分期、淋巴结转移的 MRI 表现与 p53蛋白表达的关系。方法搜集首次放疗前行 MR 检查且临床资料完整的患者104例,用链霉菌抗生物蛋白-过氧化酶免疫组织化学(SP)法检测 p53蛋白的表达,分析 T 分期、淋巴结转移的 MRI 表现与 p53的关系。结果影像学表现:104例中,经 MRI 分析 T1、T2期各32例,T3、T4期各20例;颈部淋巴结转移49例,咽后外侧淋巴结转移34例。鼻咽癌中的 p53蛋白的阳性表达率为82.7%(86/104)。T3+T4组 p53蛋白的阳性表达率92.5%(37/40),T1+T2组 p53蛋白阳性表达率为76.6%(49/64),2组之间差异有统计学意义(X~2=4.37,P=0.037)。T1、T2、T3、T4期高表达率分别为81.3%(26/32)、59.4%(19/32)、95.0%(19/20)、85.0%(17/20),p53蛋白表达强度随着 MRI 的 T 分期升高而有增加趋势(X~2=10.57,P=0.014)。颈部淋巴结转移和咽后外侧淋巴结转移的 p53蛋白阳性表达率分别为77.6%(38/49)、76.5%(26/34),淋巴结的转移与 p53蛋白的表达情况无关联(X~2值分别为0.591、0.795,P 值均>0.05);颈部淋巴结直径≥4 cm 组 p53蛋白的阳性表达率81.8%(9/11),<4 cm 组阳性表达率76.3%(29/38),二者之间的差异无统计学意义(X~2=0.005,P=0.944)。结论鼻咽癌中有较高的 p53表达,p53蛋白的过度表达可能与鼻咽癌的发生有关;p53蛋白的表达强度随着 MRI T 分期升高有增强的趋势;淋巴结的肿大与否及大小与 p53蛋白的表达无关。
Objective To investigate the relationship between the MRI findings and the expression of p53 protein in nasopharyngeal carcinoma T stage and lymph node metastasis. Methods Totally 104 patients with MR examination before complete radiotherapy and complete clinical data were collected. The expression of p53 protein was detected by streptavidin-peroxidase immunohistochemistry (SP method), and the MRI findings of T stage and lymph node metastasis were analyzed with p53 relationship. Results Imaging findings: In 104 cases, there were 32 cases in T1 and T2 and 20 cases in T3 and T4 respectively. There were 49 cases of cervical lymph node metastasis and 34 cases of retro-pharyngeal lymph node metastasis. The positive rate of p53 protein in nasopharyngeal carcinoma was 82.7% (86/104). The positive expression rate of p53 protein in T3 + T4 group was 92.5% (37/40), while the positive expression rate of p53 protein in T1 + T2 group was 76.6% (49/64). The difference between the two groups was statistically significant (X ~ 2 = 4.37, P = 0.037). The high expression rates of T1, T2, T3 and T4 were 81.3% (26/32), 59.4% (19/32), 95.0% (19/20) and 85.0% (17/20), respectively The MRI T stage increased with an increasing trend (X ~ 2 = 10.57, P = 0.014). The positive rates of p53 protein in cervical lymph node metastasis and retropharyngeal lymph node metastasis were 77.6% (38/49) and 76.5% (26/34), respectively. There was no correlation between the lymph node metastasis and p53 protein expression (P <0.05). The positive expression rates of p53 protein in cervical lymph nodes ≥ 4 cm were 81.8% (9/11), and those in <4 cm group were 76.3% (29/38) The difference between the two was not statistically significant (X ~ 2 = 0.005, P = 0.944). Conclusions There is a high expression of p53 in NPC and overexpression of p53 may be related to the occurrence of NPC. The expression of p53 is increased with the increase of MRI T stage. Size and p53 protein expression has nothing to do.