p16过表达在癌变中的临床意义

M. Perera, I. Perera
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引用次数: 0

摘要

当组织学和其他临床诊断不足以确定肿瘤结节转移(TNM)分期时,需要分子标志物来确定某些类型肿瘤的治疗方案。普遍存在的p16基因是其中之一,因为满足了作为有用生物标志物的标准而受到欢迎。p16的过表达,以补偿另外两个肿瘤抑制基因(TSG)s, pRb和p53分别因E7和E6高危人乳头瘤病毒癌蛋白整合到宿主角化细胞中而失去活性,有助于考虑p16生物标志物在癌变中的临床影响。p16免疫组织化学有助于宫颈和口咽鳞状细胞癌的诊断和预后,尽管p16阳性的临界值存在歧义。p16阳性在肺癌、乳腺癌和结直肠癌中的临床影响也再次引起人们的兴趣。高风险的人乳头瘤病毒基因型已被确定为宫颈癌、其他罕见的肛门生殖器和口咽癌(特别是扁桃体和舌底)的病因。与非HPV相关的头颈癌相比,HPV相关的头颈癌表现出独特的肿瘤生物学,因此,在个性化精准医疗的时代,最有效的治疗计划包括咨询是非常需要的,以最大限度地提高HPV相关癌症患者的总体生存率。在光明的照耀下,这一交流揭示了p16过表达在癌变中的临床意义,不局限于宫颈癌和头颈癌(HNSCC)的一个子集。
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Snapshot of Clinical Implications of p16 Overexpression in Carcinogenesis
Molecular markers are needed to decide the treatment plans of certain cancer types when the histological and other clinical diagnoses are not sufficient to decide the tumor nodular metastasis (TNM) stage. The ubiquitous p16 gene is one of them gained popularity by fulfilling criteria to be a useful biomarker. Over expression of p16, to compensate the inactivity of another two tumor suppressor genes (TSG)s, pRb and p53 due to the integration of E7 and E6 high risk Human Papilloma viral oncoprotein respectively into the host keratinocytes is useful to consider the clinical impact of p16 biomarker in carcinogenesis. The p16 immunohistochemistry helps the diagnosis as well as prognosis of cervical and oropharyngeal squamous cell carcinoma, though there are ambiguities in the cutoff values of p16 positivity. There is also a re-emerging interest on clinical impact of p16 positivity in lung, breast, and colorectal cancer types. High risk HPV genotypes have been already established as the aetiological agents of cervical, other rare ano-genital and oropharyngeal (especially tonsils and base of the tongue) cancers. The HPV associated subset of head and neck cancers demonstrate a unique tumor biology, when compared with HPV non associated ones thus, most effective treatment planning including counselling is much needed to maximize the overall survival of HPV associated cancer patients, in the era of personalized precision medicine. In the shed of light, this communication glimpses on clinical implications of p16 overexpression in carcinogenesis not limiting to cervical and a subset of head and neck carcinomas (HNSCC).
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