吲哚胺2，3-二氧酶在CINⅠ～Ⅲ及宫颈鳞状细胞癌组织中的表达及临床意义  

Indoleamine 2, 3-Dioxygenase Expression in and CINI-Ⅲ and Squamous Cell Carcinoma of the Uterine Cervix and Its Clincal Significance

作　　者：陈琬玲[1] 杨承纲[2] 杨宏英[2] 卢玉波[2] 张红平[2] 严志凌[2] 黄云超[3] 

机构地区：[1]昆明医学院 [2]昆明医学院第三附属医院妇瘤科,昆明市650106 [3]昆明医学院第三附属医院胸心外科

出　　处：《中国肿瘤临床》2010年第4期209-212,共4页Chinese Journal of Clinical Oncology

基　　金：云南省科技厅应用基础研究联合专项资金资助(编号:2008CD033)

摘　　要：目的:探讨吲哚胺2,3-二氧酶(indoleamine2,3-djoxygenase,IDO)在宫颈鳞癌发生发展中的作用。方法:选择2008年1月至12月在昆明医学院第三附属医院病理确诊为宫颈上皮内瘤样病变(ceFvical intraepithelial neoplasia,CIN)Ⅰ～Ⅲ和宫颈鳞癌的病灶组织石蜡标本116例及转移淋巴结石蜡标本18例。以正常宫颈组织石蜡标本20例及无转移淋巴结组织石蜡标本20例作为对照,采用免疫组化方法分析组织中IDO的表达。结果:正常宫颈(20例)及CINⅠ组织(10例)中IDO表达均为阴性,20%(2/10)的CINⅡ期组织表达为弱阳性,其余为阴性(80%,8/10),CINⅢ中有61.5%(8/13)的组织呈弱阳性表达,7.7%(1/13)的组织为阳性表达,30.8%(4/13)的组织为阴性表达,宫颈癌Ⅰ～Ⅳ的阳性表达率为100%(83/83),ⅠA期和ⅠB期阳性表达率显著高于CINⅡ和CINⅢ(P<0.01),ⅡA～ⅣB阳性表达率显著高于ⅠA期和ⅠB期(P<0.01)。IDO表达与宫颈癌进展有关(OR=0.807,P<0.01)。淋巴结转移阳性患者的宫颈癌组织阳性表达率显著高于淋巴结转移阴性患者(P<0.01),淋巴结转移组织中阳性表达率显著高于淋巴结转移阴性组织(P<0.01),IDO阳性表达率与肿瘤分化程度无关(OR=-0.139,P>0.05)。结论:从CINⅡ开始,肿瘤组织已逐步建立有利于肿瘤发展的免疫逃逸机制,转移淋巴结IDO表达阳性可能与机体免疫系统选择性免疫耐受有关。IDO的表达与疾病进展有关而与肿瘤组织分化程度无关,IDO可能成为宫颈鳞状细胞癌预后的预测因子及治疗靶点。Objective： To investigate the role of indoleamine 2, 3-dioxygenase in the development of uterine cervical squamous carcinoma. Methods： From January 2008 to December 2008, 116 uterine cervical carcinoma specimens and 18 metastatic lymph node specimens from patients with CIN Ⅰ -Ⅲ and uterine cervical squamous carcinoma were evaluated for IDO expression by immunohistochemistry. Twenty normal cervical specimens and 20 normal lymph node specimens were used as the controls. Results： The expression of IDO was not found in normal cervix and CIN Ⅰ. In CIN Ⅱ, IDO expression was weakly positive in 2 cases （2/10, 20%） and negative in 8 cases （8/10, 80%）. In CIN Ⅲ, IDO expression was weak- ly positive in 8 cases （8/13, 61.5%）, positive in 1 case （lj13, 7.7%） and negative in 4 cases （4/13, 30.8%）. The positive ex- pression rate of IDO in cervical cancer stage Ⅰ -Ⅳ was 100% （83/83）. In cervical cancer stage Ⅰ A and Ⅰ B, the positive expression rate of IDO was significantly higher than that in CIN Ⅲ and CIN Ⅲ （P〈0.01）. The positive expression rate of IDO in cervical cancer stage Ⅱ A-ⅣB was significantly higher than that in Ⅰ A and Ⅰ B. IDO expression was associated with cervical cancer progression （OR=0.807, P〈0.01）. IDO expression in primary lesions with lymph node metastasis was significantly higher than that in those without lymph node metastasis. IDO expression rate was 100% in metastatic lymph nodes. The IDO expression was not associated with cervical squamous carcinoma differentiation degree （OR=-0.139, P〉0.05）. Conclusion： In CIN Ⅱ, escape mechanisms that stimulate cervical squamous carcinoma progression is gradually developed. IDO expression in metastatic lymph nodes is possibly associated with immune tolerance. IDO expression is not associated with differentiation degree of cervical squamous carcinoma. IDO may be a prognostic factor for uterine cervical squamous carci noma and a therapeutic target for treatment

关 键 词：吲哚胺2 3-二氧酶 宫颈上皮内瘤样病变 宫颈鳞状细胞癌 免疫逃逸 

分 类 号：R737.33[医药卫生—肿瘤] R965[医药卫生—临床医学]