臺灣博碩士論文加值系統

本研究針對台大醫院1978年至1993年間發生於主要唾液腺的56例上皮癌,
進行Epstein-Barr(EB)病毒關聯性, 及預後相關之抑癌基因表現和組織病
理因素之探討. 本研究以原位雜交反應法偵測EB病毒, 並以免疫組織化學
染色偵測p53, RB蛋白, 與PCNA之表現.本研究進行EBER1原位雜交反應,
發現7例淋巴上皮瘤樣癌(LELC)皆呈現EBER1陽性, 且EBER1陽性反應僅見
於上皮細胞. 其他49例唾液腺癌則皆為EBER1陰性. LELC之四年存活率
達86%, 與黏液表皮樣癌及腺樣囊狀癌 (82%)相當, 但遠優於分化差之腺
癌及唾液管癌(0%).免疫組織染色方面, PCNA指數大於40之唾液腺癌之五
年存活較差(P< 0.005), 而p53指數大於20者之預後亦較差(P<0.05). EB
病毒相關之七例 LELC比其他唾液腺癌更常見p53指數大於10 (P<0.004),
顯示p53過度表現與EB病毒感染有關. RB蛋白之表現則與預後無關.

To elucidate the role of Epstein-Barr virus (EBV) and progno-
stic factors in salivary gland carcinomas, the 56 cases of
carci- nomas of major salivary glands were investigated. EBV
transcripts were examined by in situ hybridization using
oligoprobe for EBER1 on formalin-fixed paraffin-embedded tissue
sections. EBER1 was detected in the malignant epithelial cells
in all 7 cases of lymphoepithelioma-like carcinoma (LELC), but
not in any of the other carcinomas. The 7 cases of LELC had a
disease-free 4-year survival rate of 86%. The survival rate was
similar to those (82%) of adenoid cystic carcinoma and
mucoepidermoid carcinoma, but far better than those (0%) of
poorly-differentiated adeno- carcinoma and salivary duct
carcinoma. In the mean time, we per- formed immunohistochemical
staining to detect PCNA, p53, and RB protein. Tumors with high
PCNA index (>40) had poor prognosis (P<0.005), while tumors
with high p53 index (>20) also had poor outcome (P<0.05).
Overexpression of p53 (>10) was more commonly observed in EBV-
associated LELC than in other carcinomas (P< 0.004). This
finding suggests that p53 overexpression is associ- ated with
EBV infection. Thirteen cases (23%) revealed partial loss of RB
protein, while the remaining cases had RB protein expression in
almost all tumor cells.