| In head and neck squamous cancer , the oropharyngeal , hypopharyngeal and supraglottic laryngeal cancer have strong invasiveness , high metastatic rate , and poor prognosis . The study of combining therapy found that there are difference in therapeutic response and prognosis of different patients . How a-bout assessing the influence of surgical operation , anticarcinogenic drugs , and radiotherapy on prognosis has lacked scientific evidence presently . Some specially biological changes and mechanism of tumors need further be explored to i-dentify the patients in riskful condition for active treatment to them.The material of oropharyngeal , hypopharyngeal and supraglottic laryngeal cancer is used as data of this experiment . The expression of mutational P53 , Bcl-2 and P-gp proteins were detected with immunohistochemistry . By synthetical analysis of combing these results with some relative prognostic factors , the important determinant of these 3 molecular biological index on the prognosis and predicting sensitivity to postoperative radiotherapy or chemotherapy was explored . All above results may provide some evidence for selecting scientific , proper therapy clinically.Material and Methods63 cases of head and neck squamous carcinomas from 1998 to 2001 in my hospital were selected random . Among them , oropharyngeal cancer were 11 cases, hypopharyngeal cancer 21 ones , supraglottic laryngeal cancer 31 cases. 53 cases were male, 10 female . The mean age was 58. 9 years (range , 32 ~74 years ). All the patients were not treated with radiotherapy and anticarcinogenictherapy before operation . Their operation patterns were similar roughly . The postoperative pathology were all the squamous cell cancer . All the cases was divided into the simple operation group (25 cases ) and postoperative radiotherapy and/or chemotherapy group ( 38 cases ) . They all had entire clinical therapeutic and follow - up data . The deadline of follow - up time is March 2003 . The shortest follow - up time was 5 months , the longest follow - up time 62 months . The follow - up rate was 95.2%.The chosen 63 paraffin - embedded specimens of squamous cancer in head and neck were cut into slices 5m thick , and divided into P53 , Bcl-2 and P-gp groups . The streptomycin boiphilic peroxidase method ( S-P method ) was used to detect expression of P53 , Bcl-2 and P-gp proteins in oropharyngeal , hypopharyngeal and supraglottic laryngeal cancer . The negative control is phosphate - buffered saline ( PBS ) that replaced the first antibody . The determination of immunohistochemical results are : P53 protein is located in nuclei , and its positive staining is tan and brown granules . Bcl-2 and P-gp protein is located in cytoplasm and cell membrane , their positive result is tan and brown granules.10 high power fields was counted . The positive cells < 10% was negative (-). 10% -50% of positive cell was positive ( + ) , more than 50% of positive cell was strong positive ( ++ ) . According to PTNM standard of UICC 1987 , the histopathology and TNM were graded . The used statistical methods are x2 test , Ion - rank test , logistic regression and Cox model test in SPSS 11. 0 software .ResultsIn 63 cases of oropharyngeal , hypopharyngeal and supraglottic laryngeal cancer , male is 88. 3% . The rate of cervical lymph node metastasis was 57. 1% . The expression of P53 , Bcl-2 and P-gp proteins were 71.4% , 47.6% and 42. 9% respectively . 60. 3% of 63 cases were treated by combining thera-py1. In univariate analysis of therapeutic method and survival result , thedifference between the survival or dead / recurrent cases in operation group and that in postoperatively therapeutic group was not statistically significant ( P = 0. 051) . In multivariate analysis by Cox model , the relative association didn't be showed (P =0.752) , suggesting that the therapeutic means is not main factor.2. By analysis of results in both simple operation and postoperative radiotherapy or chemotherapy groups , the survival rates between P53...
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