口腔鳞状细胞癌的DNA定量分析及临床意义

目的：运用ICM-DNA定量分析系统研究口腔鳞状细胞癌的DI值及倍体分布情况，评估其与口腔鳞状细胞癌的临床病理因素的关系。 方法：收集口腔鳞癌石蜡标本79例作为实验组，25例口腔正常黏膜组织和30例口腔黏膜异常增生作为对照组，经Feulgen染色后分组进行ICM-DNA定量分析。 结果：实验组79例口腔鳞状细胞癌中异倍体出现率为55.7%（44/79），均明显高于对照组正常组织的 0.0%（0/25）和口腔黏膜异常增生的46.7%(14/30)，P=0.000；口腔黏膜异常增生组轻、中、重度三组间比较，异倍体出现率分别为0%（0/2）、14.3%（1/7）、61.9%（13/21），P=0.036；口腔鳞癌组高及中低分化组间比较，高分化组异倍体出现率42.5%（20/47）低于中低分化组为75 % (24/32)，P=0.004；有淋巴结转移的有78.6%出现异倍体（22/28）,高于无淋巴结转移的43.1%(22/51)，P=0.002,但异倍体出现率与年龄（P=0.193）、性别（P=0.232）、吸烟与否（P=0.151）及病变部位（P=0.915）等因素无关。 结论：口腔鳞状细胞癌中DNA异倍体出现率均高于正常组织和黏膜异常增生，并可能与分化程度及有无淋巴结转移有关。ICM-DNA定量分析对于口腔鳞癌的诊断以及恶性程度的判断提供有价值的临床指标，有望用于口腔鳞癌的辅助性临床预测及诊断。

DNA quantitative analysis of oral squamous cell carcinoma and its clinical significance

Objective: To study the DI value and ploidy distribution of oral squamous cell carcinoma (OSCC) by ICM-DNA quantitative analysis system, and to evaluate its relationship with clinicopathological factors of OSCC. Methods: 79 paraffin specimens of OSCC were collected as experimental group, 25 cases of normal oral mucosa tissue and 30 cases of oral mucosa epithelial dysplasia as control group.ICM-DNA quantitative analysis was carried out after Feulgen staining. Results: 79 cases of OSCC in the aneuploidy occurrence rate was 55.7% (44/79), were significantly higher than the control group of 0% normal tissues (0/25) and oral mucosa epithelial dysplasia (14/30) 46.7%, P =0.000; Compared with mild , moderate and severe three groups of oral mucosa epithelial dysplasia , the rate of aneuploidy occurrence was 0 % ( 0 / 2 ) , 14.3 % ( 1 / 7 ) , 61.9 % ( 13 / 21 ) , P = 0.036 , respectively ;high and moderate-poor differentiation between the three groups, aneuploidy occurrence rate of high differentiation group at the rate of 42.5% (20/47) lower than the moderate-poor differentiation group was 75% (24/32), P =0.004; lymph node metastasis group have 78.6% aneuploidy occurrence rate (22/28), higher than that without lymph node metastasis 43.1% (22/51),P =0.002.The incidence of aneuploidy was not associated with age (P=0.193), sex (P=0.232) ,smoking (P=0.151) and the location of the disease (P=0.915). Conclusion: DNA aneuploidy rate of OSCC was higher than that of normal tissue and epithelial dysplasia of oral mucosa, and may be associated with the degree of differentiation and lymph node metastasis .ICM-DNA quantitative analysis provides a valuable clinical indicator for the diagnosis of OSCC and the judgment of malignancy ,which is expected to be used for adjuvant clinical prediction and the diagnosis of OSCC