舌癌におけるp16, p21, cyclin D1遺伝子産物の発現の予後因子としての意義

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  • Cyclin D1, p16, and p21 gene product expression as a predictor of outcomes in tongue cancer
  • ゼツガン ニ オケル p16 p21 cyclin D1 イデンシ サンブツ ノ ハツゲン ノ ヨゴ インシ ト シテ ノ イギ

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We evaluated the prognostic significance of the expression of p16, p21, and cyclin D1 in surgically resected squamous cell carcinomas (SCCs) of the tongue from 52 patients. Patients in this study underwent resection of SCC of the tongue in the Department of Oral and Maxillofacial Surgery, Tokyo Dental College from February 1996 through March 2003. The study group comprised 35 men and 17 women, with an average age of 58.0 years. The average observation period was 2105 days. A high nodal metastasis grade (N) was associated with poor survival (log-rank test, N0/N2 P = 0.0402, N1/N2 P = 0.0180). We sliced sections and performed immunohistochemical staining for p16, p21, and cyclin D1. Specimens with at least one positively stained field were judged to be positive, and positivity was classified into three levels on the basis of expression. In resected tumors, the nucleus positive rates of p16, p21, and cyclin D1 were 32.7 % (17/52), 90.4 % (47/52) , and 76.9 % (40/52), respectively. pN factor was significantly related to outcomes on Cox proportional-hazards multivariate regression analysis (P = 0.006). Survival in patients with cyclin D1 overexpression (cyclin D1 (＋＋＋)) was poorer than that in cyclin D1-negative patients (log-rank test, P = 0.0415). There was no significant relation between p16 or p21 expression and outcomes. These results suggest that N factor is a significant prognostic factor in patients with SCCs. In addition, overexpression of cyclin D1 may be related to outcomes.

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