目的

通过检测舌鳞癌和癌前病变组织中人端粒酶逆转录酶 （human telomerase reverse transcriptase，hTERT）蛋白与P53 调控蛋白（P63／P53／P21／MDM2）的表达水平，分析其相关性并进一步探讨它们与舌鳞癌发生发展的关系。

方法

采用免疫组化SP 法检测47 例舌鳞癌、7 例口腔黏膜白斑、11 例正常舌上皮中hTERT、P63、P53、P21、MDM2 蛋白的表达情况。

结果

hTERT蛋白在舌鳞癌、口腔黏膜白斑中阳性表达率分别为76.6%和42.9%，在正常舌上皮中检测不到其表达；癌组织中P21^WAF1 表达降低，P53 和MDM2 蛋白表达升高（P ＜0.05）；而P63 在各组中均高水平表达（P ＞0.05）；hTERT 水平与MDM2 的表达具有正相关的关系（r＝0.51），与P21^WAF1 和P63蛋白表达无相关性。

结论

hTERT 表达上升是舌鳞癌发生的早期事件，P21^WAF1 和MDM2 可能通过参与hTERT 表达调控，在部分舌鳞癌发生发展过程中起重要作用。

Objective

To determine the expression of hTERT and P53 pathway proteins （P63／P53／P21／MDM2） in tongue squamous cell carcinoma （TSCC） and precancerous lesions， and analyze their correlationship.

Methods

Immunohistochemical SP method was performed to detect the levels of hTERT， P63， P53， P21 and MDM2 proteins in 47 cases of TSCC tissues， 7 cases of oral leukoplakia lesions， and 11 cases of normal tongue epithelia.

Results

The positive expression levels of hTERT protein in normal， oral leukoplakia， and TSCC were 0， 42.9%， and 76.6%， respectively （P ＜0.01）. The positive rates of P53 and MDM2 protein were up-regulated， while the expression level of P21^WAF1 was down-regulated compared to oral leukoplakia and normal tongue tissues （P ＜0.05）.Further analysis indicated that there was a positive correlation between P21^WAF1 level and the expression of hTERT protein （r＝0.51）. Additionally， positive staining of P63 was detected in almost all TSCC lesions and normal tongue tissues.

Conclusions

That the activation of hTERT is an early event in tongue carcinogenesis. Moreover， loss of P21^WAF1 may synergistically act with hTERT upon the establishment and progression of TSCC. In contrast， P53 and MDM2 are likely to play important roles in certain tongue malignancies.