女性宫颈鳞状上皮内病变的克隆性  

Clonality of squamous intraepithelial lesion of cervix

作　　者：朱少君[1] 李艳红 张伟[1] 赵宏喜[2] 巩丽[1] 兰淼[1] 李爱宁[1] 

机构地区：[1]第四军医大学唐都医院病理科,陕西西安710038 [2]第四军医大学唐都医院妇产科,陕西西安710038

出　　处：《第四军医大学学报》2006年第17期1537-1541,共5页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金(30171052);国家回国人员研究启动基金(Hg98004);陕西省卫生厅科研基金(02D02)

摘　　要：目的根据女性体细胞中两条X染色体上雄激素受体(AR)基因的长度多态性进行非放标克隆性检测,以探讨宫颈鳞状上皮内病变的克隆组成.方法用石蜡切片,HE染色后进行显微解剖,提取基因组DNA,经HhaⅠ消化后,巢式PCR扩增,变性聚丙烯酰胺凝胶电泳后银染显示单股DNA片段长度.结果在73例鳞状上皮内病变(SIL)标本中,CINⅠ级病变26例,其中24例(92.3%)具有AR位点的多态性,2例(8.3%)显示AR位点长度多态性丢失,其余22例(91.7%)无多态性丢失.CINⅡ级病变23例,其中20例(87.0%)具有AR位点的多态性,13例(65.0%)显示AR位点长度多态性丢失,其余7例(35.0%)无多态性丢失;CINⅢ病变24例,其中21例(87.5%)具有AR位点的多态性,2例标本间质成分检测结果表现为条带偏移,不适于此项检测,其余19例均显示AR位点长度多态性丢失.单克隆性病变的核分裂指数明显高于多克隆病变,但二者的凋亡小体计数无显著差别.结论大部分Ⅰ级CIN病变和少部分Ⅱ级CIN病变属于多克隆性病变,是反应性增生;大部分Ⅱ级CIN病变和全部Ⅲ级CIN病变是克隆性增生,可能已经属于真性肿瘤.AIM： To demonstrate the clonality status of squamous intraepithelial lesion （SIL） of cervix using an assay based on inactivation mosaicism of the length-polymorphic X chromosomes at the androgen receptor （AR） locus. METHODS： Proliferative epithelial component of the SIL was collected by using microdissection from the routine sections stained with hematoxylin and eosin. Stromal component was also isolated from the same samples, and used for parallel controls. Genomic DNA was extracted, pretreated with Hha I, and amplified via nested PCR. The products were resolved on denaturing polyacrylamide gels and visualized through silver staining. RESULTS： A total of 73 cases were examined, including 26 samples of CIN Ⅰ , 23 samples of CIN Ⅱ and 24 samples of CIN Ⅲ. All the samples was successfully amplified and 65 of them （ 24 samples of CIN Ⅰ , 20 samples of CIN Ⅱ and 21 samples of CIN Ⅲ ） carried the length polymorphism at the AR locus. Monoclonal composition was demonstrated in 2 of 24 samples of CIN Ⅰ , 13 of 20 samples of CIN Ⅱ and 19 of 19 samples of CINⅢ. Mitotic indices of the monoclonal lesions were higher than those of the polyclonal lesions, but no difference was found between their apoptotic body counts. CONCLUSION： In cervix, most of CIN Ⅰ and some of CIN Ⅱ are polyclonal, thereby being responsive proliferative lesions. Most of the CIN Ⅱ and all of CIN Ⅲ show monoclonal cell expansion, and they may be already neoplastic.

关 键 词：鳞状上皮内病变 克隆性分析 雄激素受体 X染色体 肿瘤 

分 类 号：R711.7[医药卫生—妇产科学]