摘要目的 研究喉基底样鳞状细胞癌(basaloid squamous cell carcinoma,BSCC)中人乳头状瘤病毒(HPV)及细胞周期相关蛋白的表达及意义.方法 收集北京同仁医院2005年1月至2011年12月332例喉鳞状细胞癌(SCC)病理资料,包括303例普通型SCC及29例喉BSCC,回顾性分析其中29例喉BSCC(8.7％)临床病理学特点,采用聚合酶链反应(PCR)反向点杂交方法检测HPV DNA,免疫组织化学SP法染色观察细胞周期相关蛋白p53、Ki-67、p16、p21、cyclin D1的表达,比较分析以上指标与肿瘤大小、分期、部位、淋巴结转移等主要病理学特点的关系,初步探讨HPV与细胞周期相关蛋白之间的相关性.结果 (1)29例喉BSCC男性27例,女性2例,年龄46～82岁(中位年龄62岁),与普通型SCC相比,发病年龄、淋巴结转移个数、淋巴结转移率及声门上肿瘤的发生率略高,但差异无统计学意义(P>0.05).(2)喉BSCC中27.6％(8/29)检测到HPV DNA,且均为HPV16,HPV的表达与年龄、是否饮酒及分期、肿瘤大小等无关(P>0.05).(3)31.0％(9/29)的喉BSCC表达p53,且p53阳性病例更容易发生于声门上并伴有淋巴结转移(P<0.05).p16的阳性表达率为24.1％(7/29),其淋巴结转移率略高于p16阴性病例,p21、cyclin D1的表达率分别为27.6％(8/29)和69.0％(20/29),与年龄、肿瘤大小、分期、淋巴结转移、是否吸烟、饮酒等均无相关性(P>0.05).(4)8例HPV阳性的BSCC只有3例p16阳性,HPV阳性组p21及Ki-67阳性指数比HPV阴性组增高(P<0.05).结论 部分喉BSCC表达HPV,个别病例可能为HPV相关性喉BSCC,p16表达并不是喉BSCC HPV感染的可靠替代性指标.

abstractsObjective To study the significance of HPV and cell cycle related proteins in basaloid squamous cell carcinoma ( BSCC ) of the larynx. Methods Twenty-nine cases of laryngeal BSCC from Beijing Tongren Hospital from January 2005 to December 2011 were reviewed. HPV typing by polymerase chain reaction-reverse dot blot ( PCR-RDB ) and p53, Ki-67, p16, p21 and cyclin D1 expression by immunohistochemistry were performed. The relationship between these indicators, various pathologic parameters ( TNM, tumor size, tumor site and lymph node metastasis ) and HPV status was analyzed. Results There were 27 male and 2 female patients. The median age was 62 years. Lymph node metastasis and supraglottic tumor location were slightly higher than that of"usual" SCC, but not statistically significant (P>0. 05). HPV DNA was detected in 27. 6％ (8/29) of the laryngeal BSCC, and all were HPV16. The expression of HPV was not related to age, alcohol consumption, tumor stage and tumor size. p53 was expressed in 31. 0％( 9/29) of laryngeal BSCC, and these cases were more likely supraglottic and had lymph&nbsp;node metastases (P<0. 05). p16 staining was seen in 24. 1％ (7/29) of laryngeal BSCC, and these cases showed slightly higher rate of lymph node metastasis compared to p16 negative cases. The expression rates of p21 and cyclinD1 were 27. 6％ (8/29) and 69. 0％(20/29), respectively, which were not related to age, tumor size, stage, lymph node metastasis, smoking and drinking. There were only 3 p16+/HPV+ cases, which showed higher p21 and Ki-67 index compared to the HPV negative group (P<0. 05). Conclusion Some laryngeal BSCC expresses HPV DNA, possibly indicating an association with HPV;but p16 expression is not a reliable indicator for HPV infection.