上海口腔医学

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (6): 644-647.doi: 10.19439/j.sjos.2019.06.018

• 论著 • 上一篇    下一篇

高危TP53突变与口腔鳞状细胞癌中淋巴结外侵犯的相关性分析

石磊, 陶峰, 刘瑞敏, 刘巧蓉   

  1. 甘肃省人民医院 口腔颌面外科,甘肃 兰州 730000
  • 收稿日期:2019-06-11 出版日期:2019-12-25 发布日期:2020-01-14
  • 通讯作者: 石磊,E-mail：lszonesky@163.com
  • 作者简介:石磊（1979-）,男,硕士,主治医师

Correlation between high-risk TP53 mutation and extracapsular spread in oral squamous cell carcinoma

SHI Lei, TAO Feng, LIU Rui-min, LIU Qiao-rong   

  1. Department of Oral and Maxillofacial Surgery, Gansu Provincial People's Hospital. Lanzhou 730000,Gansu Province,China
  • Received:2019-06-11 Online:2019-12-25 Published:2020-01-14

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摘要： 目的 探讨高危肿瘤蛋白53（tumor protein p53,TP53）突变与口腔鳞状细胞癌（oral squamous cell carcinoma,OSCC）淋巴结外侵犯（extracapsular spread,ECS）的相关性。方法 回顾性分析2013年1月—2016年1月甘肃省人民医院口腔颌面外科收治的88例OSCC患者资料。根据有无淋巴结转移分为无淋巴结转移组（A1）、淋巴结转移不伴ECS组（A2）、淋巴结转移伴ECS组（A3）。比较各组TP53基因外显子（5-8）在原发灶及转移灶的缺失情况;ECS与无病生存率（disease-free survival,DFS）及总生存率（overall survival,OS）的相关性,TP53突变状态与ECS的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果 A1组、A2组及A3组均发现TP53（5）纯合子缺失;A3组（10/30）发现TP53（6）纯合子缺失;A1组、A2组及A3组均未发现TP53（7）纯合子缺失;A2组（7/42）、A3组（10/30）及A3组（10/60）发现TP53（8）纯合子缺失;A1组1年和3年DFS分别为75.00%和70.83%,A2组1年和3年DFS率分别为70.59%和58.82%,A3组1年和3年DFS分别为46.67%和40.00%,A3组1年和3年DFS显著低于其他2组（P<0.05）;A1组1年和3年OS分别为83.33%和75.00%,A2组1年和3年OS分别为73.53%和50.00%,A3组1年和3年OS分别为46.67和40.00%,A3组1年和3年OS显著低于其他2组（P<0.05）;A3组发生TP53低危型突变（LR）4例（13.33%）,TP53高危型突变（HR）12例（40.00%）,TP53野生型突变（Wt）4例（13.33%）,其他突变10例（33.33%）。其中,HR型突变与其他突变较其他类型发生例数多（P<0.05）;吸烟、原发灶范围、野生型/低风险与高风险/其他与ECS存在相关性（P<0.05）。结论 OSCC患者中ECS是DFS与OS的重要标志物,且ECS中以高危突变较为常见,说明TP53高危突变与OSCC中ECS存在一定相关性。

关键词: TP53, OSCC, 淋巴结外侵犯, 基因突变, 相关性

Abstract: PURPOSE: To investigate the correlation between high-risk tumor protein p53 (TP53) mutation and extracapsular spread(ECS) in oral squamous cell carcinoma (OSCC). METHODS: The data of 88 OSCC patients admitted to Gansu Provincial People's Hospital from January 2013 to January 2016 were retrospectively analyzed. The patients were divided into non-lymph node metastasis group (A1), lymph node metastasis without ECS group (A2), lymph node metastasis with ECS group(A3) according to the presence or absence of lymph node metastasis. The deletion of exon 5-8 of TP53 gene in primary and metastatic lesions was detected. The correlation of ECS with disease-free survival(DFS), overall survival(OS) rate and TP53 mutation were determined, and single factor analysis of ECS was performed. The data were analyzed by SPSS 20.0 software package. RESULTS: TP53 (5) homozygote deletion was found in all three groups. TP53 (6) homozygous deletion was found in group A3 (10/30). No homozygous deletion of TP53(7) was found in three groups.Homozygous deletion of TP53 (8) was found in group A2(7/42), group A3(10/30) and group A3(10/60).The 1-year and 3-year DFS rates were 75.00% and 70.83% in group A1, 70.59% and 58.82% in group A2, 46.67% and 40.00% in group A3, with significant difference(P<0.05). The 1-year and 3-year OS rates were 83.33% and 75.00% in group A1, 73.53% and 50.00% in group A2, 46.67% and 40.00% in group A3 , with significant difference(P<0.05). In group A3, there were 4 cases (13.33%) of low-risk TP53 mutation (LR), 12 cases (40.00%) of high-risk TP53 mutation (HR), 4 cases(13.33%) of wild-type TP53 mutation (Wt), and 10 cases(33.33%) of other mutations. HR mutation and other mutations occurred more frequently than other types(P<0.05). Smoking, primary lesion size, wild type/low risk and high risk/others were correlated with ECS(P<0.05). CONCLUSIONS: ECS is an important marker of DFS and OS in OSCC patients, and high-risk mutations were common in ECS, indicating a certain correlation between high-risk mutations of TP53 and ECS in OSCC.

Key words: TP53, OSCC, ECS, Gene mutation, Correlation

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