P34cdc2於口腔癌前病變及口腔鱗狀細胞癌之表現

Abstract

背景：P34cdc2在人類不同的癌症中被發現有過度表現的現象，而且和腫瘤的大小、淋巴結的轉移、臨床的分期、或病人的預後等有統計上有意義的相關。 方法：本研究利用免疫組織化學染色的方法，探討P34cdc2於81例口腔鱗狀細胞癌（OSCC），95例口腔上皮變異（ED；29例輕度，43例中度，23例重度上皮變異），和14例正常口腔黏膜（NOM）之表現。我們計算在口腔鱗狀細胞癌、口腔上皮變異與正常口腔黏膜中的細胞質P34cdc2標記指數（labeling indices, LIs），並比較各組間的差異。我們同時利用統計方法來分析細胞質P34cdc2標記指數與口腔鱗狀細胞癌病人的臨床病理參數與存活率的相關性。 結果：細胞質P34cdc2平均標記指數，從NOM之6±7%，至輕度ED之18±10%，至中度ED之23±11%，至重度ED之40±22%，至OSCC之73±20%，有隨著惡性程度的增加而呈現統計學上有意義增高的情形（P=0.000)。統計分析的結果也顯示，細胞質P34cdc2平均標記指數在OSCCs中之較高表現和OSCCs發生在有局部淋巴結的轉移,較高的臨床分期與較高度分化之病理組織學上分類的程度，有統計學上有意義之相關。 結論：我們的結果顯示， P34cdc2的表現度可以在口腔癌的初期形成而且也扮演一個重要的角色。因此細胞質P34cdc2標記指數可預測台灣OSCC的進展。

Background: Overexpression of p34cdc2 has been demonstrated in a variety of human cancers and found to be significantly associated with the tumor size, lymph node metastasis, clinical stage, or prognosis of these cancers. Methods: In this study, we examined the expression of p34cdc2 in 81 specimens of oral squamous cell carcinoma (OSCC), 95 specimens of oral epithelial dysplasia (OED; 29 mild, 43 moderate, and 23 severe OED cases), and 14 specimens of normal oral mucosa (NOM) by immunohistochemistry. The cytoplasmic p34cdc2 labeling indices (LIs) in OSCC, OED, and NOM samples were calculated and compared between groups. The correlation between the cytoplasmic p34cdc2 LI in OSCCs and clinicopathological parameters or survival of OSCC patients was analyzed statistically. Results: The mean cytoplasmic p34cdc2 LIs increased significantly from NOM (6±7%) through mild (18±10%), moderate (23±11%), and severe OED (40±22%) to OSCC samples (73±20%, P = 0.000). A significant correlation was found between the higher mean cytoplasmic p34cdc2 LIs and positive regional lymph node metastases (P = 0.013), more advanced clinical stages (P = 0.022) or higher differentiation of cancer cells (P = 0.028). Conclusion: Our results suggest that the p34cdc2 expression is an early event in oral carcinogenesis and may play an important role in oral carcinogenesis. The cytoplasmic p34cdc2 LI may be used as a biomarker to predict the progression of OSCCs in Taiwan.