目的:探讨MAGEA1及MAGEA3蛋白在头颈部鳞癌的发生过程中的表达以及在头颈部鳞癌及癌旁组织中的表达情况,了解其与头颈部鳞癌发生的相关性,并为鳞癌手术安全切缘的范围提供理论依据。方法:利用诱癌剂4-硝基喹啉-1-氧化物饮水法建立头颈部鳞癌小鼠模型。用免疫组化法检测MAGEA1、MAGEA3蛋白的在各组中的表达,包括头颈部鳞癌形成过程中的不同阶段、41例头颈部鳞癌中心区、癌旁〈5mm区、〉5mm区及正常黏膜组织。结果:与正常黏膜组织相比,头颈部鳞癌MAGEA1及MAGEA3的表达差异有统计学意义(P〈0.001),并且其不同阶段的上皮异常增生程度与MAGEA1及MAGEA3的表达程度分别呈正相关(rs=.55,P〈0.001;rs=0.49,P〈0.001)。癌中心区、癌旁〈5mm区、〉5mm区比较。MAGEA1、MAGEA3、MAGEA1和MAGEA3、MAGEA1或MAGEA3表达阳性率逐渐减小,并有显著性差异(P〈0.001),〉5mm区基本正常。结论:MAGEA1及MAGEA3蛋白在头颈部鳞癌中有较高的表达率,并与头颈部鳞癌的发生、发展中有一定的相关性,可以作为判断头颈部鳞癌发展生物学特性的参考指标。鳞癌手术切除范围以距肿瘤边缘5mm以上作为安全切缘的标准较为适宜。
Objective: To investigate the expression of MAGEA1 and MAGEA3 protein in the development of head and neck squamous cell carcinoma, as well as in the head and neck squamous cell carcinoma and adjacent tissues. It will help to know the correlation of the two proteins in head and neck squamous cell and provide satisfactory and safe surgical margin of squamous cell carcinoma. Methods: A mouse model of head and neck squamous cell carcinoma was first established with 4-nitro-quinoline-l-oxide in drinking water, then the expressions of MAGEA1 and MAGEA3 protein were determined by immunohistochemical in the different developments of head and neck squamous cell carcinoma, central and adja cent (〈5 mm, 〉5 mm area) tissue of head and neck squamous cell carcinoma (n=41), and normal mucosa tissues. Results: The expressions of MAGEA1 and MAGEA3 were significantly different between the head and neck squamous cell carcinoma and normal mucosa tissue (P〈0.001), and the degree of epithelial dysplasia in its development had a positive correlation with the two protein expressions respectively (rs=0.55, P〈0.001; rs=0.49, P〈0.001). The expressions of MAGEA1, MAGEA3, MAGEA1 and MAGEA3, MAGEA1 or MAGEA3 were significantly decreased in the central and adjacent (〈5 mm, 〉5 mm area) tissue of head and neck squamous cell carcinoma (P〈0.001). The results were near to normal level in the tissue at the area of 〉5 mm away from the cancer. Conclusion: In head and neck squamous cell carcinoma, MAGE1 and MAGE3 protein have a higher expression rate, and the results show higher correlation between them. So the two proteins could serve as a reference indicator for the biological characteristics of the development of head and neck squamous cell carcinoma. The appropriate standard for surgical resection scope of squamous cell carcinoma is more than 5 mm from the tumor edge.