脑胶质瘤中p16蛋白表达及临床意义.docVIP

脑胶质瘤中p16蛋白表达及临床意义 　【关键词】 脑胶质瘤 摘要：目的：研究抑癌基因p16蛋白在脑胶质瘤发生、分化过程中的作用及其与预后的关系。方法：本院1999年6月至2002年6月接受手术及术后立体定向放射治疗68例脑胶质瘤患者，应用免疫组化的方法检测其病理标本中的p16蛋白，分析p16蛋白的缺失与病理分级、患者预后之间的关系。结果：全组共有37例（54.4%）标本p16蛋白表达阴性，Ⅰ、Ⅱ、Ⅲ、Ⅳ级胶质瘤的p16蛋白表达阴性率分别为14.3%、33.3%、66.7%、75.0%，Ⅲ、Ⅳ级胶质瘤的p16蛋白的阴性率明显高于Ⅰ、Ⅱ级（Plt;0.01）。p16蛋白表达阴性患者的复发率明显高于p16蛋白表达阳性者（Plt;0.01），分别为54.5%和19.4%。结论：p16蛋白的缺失与脑胶质瘤的恶性程度有关，恶性程度越高，p16蛋白的缺失率越高；p16蛋白的缺失与预后相关，其缺失率越高，患者复发率越高。 关建词：脑胶质瘤；p16蛋白；外科手术；立体定向放射治疗 p16 Expression and Clinical Signficance in Brain Glioma Abstract： Objective: To investigate the correlation of p16 expression with the proliferation, malignant progression and prognosis of brain glioma. Method：68 patients of brain glioma were operated with stereotactic radiotherapy after operation from June 1999 to June 2002. Express of p16 protein of the specimens was detected by immunohisto- chemistry. The relationship between the expression of p16 protein and the pathological grade and the recurrence of the tumor were analyzed. Result： There were 37cases (54.4%) that the expression of p16 protein was positive. The positive rate of Ⅰ、Ⅱ、Ⅲ、Ⅳ pathological grade was 14.3%、33.3%、66.7% and 75.0% respectively. The positive rate of Ⅲ and Ⅳ grade was significantly higher than Ⅰand Ⅱ grade.（Plt;0.01） The recurrence rate of patients with negative expression of p16 protein (54.5%)was significant higher than the those with positive negative expression(19.4%). Conclusion： The loss or mutation of p16 gene is one of the reasons of the malignant progression in brain glioma. The immunohistochemical detection of p16 protein acts as a prognosis index for brain glioma. Key words：Glioma;p16 protein;Operation;Stereotactic radiotherapy p16基因（MTS1，CDK4I，CDKN2）是近年发现的一个抑癌基因，是细胞周期调控基因家庭中的重要成员之一，其功能蛋白能特异地抑制CDK4/CDK6的活性，间接阻断处于分裂周期的细胞从G1期向S期转变，抑制细胞增殖［1］。在多种肿瘤细胞系及临床肿瘤标本中，p16基因都有着高频率的缺失及突变，并以脑胶质瘤细胞为最高，达82%［2］，显示了它在脑胶质瘤恶性转化中的重要作用。因此，研究p16基因对脑胶质瘤的作用，对于提高脑胶质瘤诊断和治疗水平都具有重要的意义。 1材料与方法 1.1材料：1999年6月至2002年6月，本科共收治68例初治的脑胶质瘤患者，所有患者均接受开颅肿瘤切除手术，及术后立体定向放射治疗。患者中位年龄47岁（32～