CAJ | 학술논문

目的：喉癌发病率具有较大的区域性差异，其病因尚不明确。通过检测原发性喉鳞状细胞癌组织和癌旁组织RECK基因的甲基化状态，分析RECK基因启动子区的甲基化与患者预后的关系。方法采用甲基化特异性PCR检测邢台市人民医院2006年7月至2007年12月70例经外科手术切除的喉鳞状细胞癌标本的RECK基因启动子区甲基化状态，比较不同病理参数的甲基化率的差异，对完成5年随访的64例患者分析其RECK基因启动子区甲基化与预后的关系。结果肿瘤组织低分化患者的RECK基因甲基化率（86．67％）远高于中、高等分化程度的患者（43．64％），差异有统计学意义（ P＜0．05），其他病理参数间RECK基因甲基化率差异无统计学意义（P＞0．05）；29对喉鳞状细胞癌-癌旁组织匹配的标本中，喉鳞状细胞癌组织RECK基因甲基化率（55．12％）高于正常组织（27．59％），差异有统计学意义（P＝0．029）；经Log-rank分析， RECK基因甲基化可明显缩短患者的无瘤生存期和总体生存期（P＝0．024，P＝0．017）；有淋巴结转移、Ⅲ-Ⅳ级临床分期可明显缩短患者的无瘤生存期和总体生存期（P＝0．029，P＝0．024；P＝0．033，P＝0．032），肿瘤组织中等及高分化可明显缩短患者的无瘤生存期（P＝0．049）；总体生存期的独立危险因素为有无淋巴结转移、临床分期和RECK基因甲基化。结论 RECK基因启动子区甲基化是人喉鳞状细胞癌的早期事件，在癌旁正常组织中也可发生，并且与患者较差的预后关联。
목적：후암발병솔구유교대적구역성차이，기병인상불명학。통과검측원발성후린상세포암조직화암방조직RECK기인적갑기화상태，분석RECK기인계동자구적갑기화여환자예후적관계。방법채용갑기화특이성PCR검측형태시인민의원2006년7월지2007년12월70례경외과수술절제적후린상세포암표본적RECK기인계동자구갑기화상태，비교불동병리삼수적갑기화솔적차이，대완성5년수방적64례환자분석기RECK기인계동자구갑기화여예후적관계。결과종류조직저분화환자적RECK기인갑기화솔（86．67％）원고우중、고등분화정도적환자（43．64％），차이유통계학의의（ P＜0．05），기타병리삼수간RECK기인갑기화솔차이무통계학의의（P＞0．05）；29대후린상세포암-암방조직필배적표본중，후린상세포암조직RECK기인갑기화솔（55．12％）고우정상조직（27．59％），차이유통계학의의（P＝0．029）；경Log-rank분석， RECK기인갑기화가명현축단환자적무류생존기화총체생존기（P＝0．024，P＝0．017）；유림파결전이、Ⅲ-Ⅳ급림상분기가명현축단환자적무류생존기화총체생존기（P＝0．029，P＝0．024；P＝0．033，P＝0．032），종류조직중등급고분화가명현축단환자적무류생존기（P＝0．049）；총체생존기적독립위험인소위유무림파결전이、림상분기화RECK기인갑기화。결론 RECK기인계동자구갑기화시인후린상세포암적조기사건，재암방정상조직중야가발생，병차여환자교차적예후관련。
Objective The incidence of laryngeal cancer has characteristic of regional differences, but the etiology is not clear. The aim of this study was to analyze the correlation between RECK gene promoter methylation and prognosis of laryngeal squamous cell carci-noma patients through detecting the RECK gene methylation status of primary laryngeal squamous cell carcinoma and adjacent tissues . Methods Methylation specific PCR assay was used to detect the RECK gene promoter methylation status of 70 laryngeal squamous cell carci-noma specimens in our hospital from July 2006 to Dcember 2007, and the differences of methylation status with different pathological parame-ters were compared.The correlation between RECK gene promoter methylation and prognosis of 64 patients completed five-year follow-up was analyzed. Results The RECK gene methylation rate (86.67%) of patients with poor differentiation in tumor cells was much higher than that of the patients with a moderate and better tumor cell differentiation (43.64%) (P<0.05).In 29 pairs of laryngeal cancer-adjacent tis-sues specimens matches, the RECK gene methylation in laryngeal carcinoma (55.12%) was higher than normal tissues (27.59%) ( P=0.029).RECK gene methylation significantly shortened the tumor free survival and overall survival analyzed by Log-rank (P=0.024, P=0.017).Lymph node metastasis and clinical stage in classⅢ-Ⅳsignificantly shortened the tumor free survival and overall survival (P=0.029, P=0.024;P=0.033, P=0.032).Moderate and better tumor cell differentiation significantly shortened the tumor free survival (P=0.024, P=0.049).Lymph node metastasis, clinical stage, and RECK gene methylation were independent risk factors of overall survival. Conclusion RECK gene promoter methylation in human laryngeal squamous cell carcinoma is an early event and may occur in the adjacent normal tissues, predicting a poor prognosis in patients.