不同宫颈病变患者血清和宫颈病变组织中凋亡相关因子的表达及其临床意义  

Expressions of apoptosis-related factors in serum and cervix tissue of patients with different cervical lesions and their clinical significances

作　　者：于慧玲[1] 李冬梅[2] 孙勤暖[1] 马洪喜[3] 

机构地区：[1]内蒙古医科大学病理学教研室,内蒙古呼和浩特010059 [2]长春大学特殊教育学院针灸推拿系,吉林长春130022 [3]吉林大学第一医院病理科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2015年第1期129-134,I0004,共7页Journal of Jilin University：Medicine Edition

基　　金：内蒙古自治区科技厅自然科学基金资助课题(2011MS1142)

摘　　要：目的:观察凋亡相关因子在不同宫颈病变患者血清和宫颈病变组织中的表达,探讨其与宫颈鳞状细胞癌(鳞癌)临床病理特征的关系。方法:选取镜检确诊为不同宫颈病变的患者140例,其中子宫颈鳞癌70例、宫颈原位癌(CINⅢ)50例和宫颈炎20例,均空腹抽取静脉血同时留取镜检组织。采用酶联免疫法、实时荧光定量法和免疫组织化学法分别检测患者血清及不同宫颈病变组织中凋亡相关因子——肿瘤抑制基因(p53)、细胞凋亡信号受体(Fas)、肿瘤坏死因子α(TNF-α)和细胞周期素E(cyclin E)蛋白和mRNA表达,并分析其蛋白表达与宫颈鳞癌临床分期、病理类型和淋巴结转移的关系。结果:与宫颈炎患者比较,宫颈鳞癌和宫颈原位癌患者血清及宫颈组织中p53、Fas、TNF-α蛋白和mRNA表达水平均明显降低(P<0.01),而cyclin E蛋白和mRNA表达水平明显升高(P<0.01),宫颈鳞癌患者与宫颈原位癌患者比较差异无统计学意义(P>0.05);p53、Fas、TNF-α和cyclin E阳性表达率与宫颈鳞癌临床分期、病理类型和淋巴结转移均有密切关联(P<0.01)。结论:宫颈鳞癌和宫颈原位癌患者血清和宫颈病变组织中p53、Fas和TNF-α表达水平下调和cyclin E表达水平上调可能与宫颈癌的浸润和转移有关联,可作为宫颈癌早期诊断的标记物,并可为宫颈癌的术后用药和预后判断提供理论依据。Objective To observe the expressions of apoptosis-related factors in serum and cervix tissue of the patients with different cervical lesions,and to explore their relationships with the clinicopathological characteristics of cervical squamous cell carcinoma.Methods 140 patients with different cervical lesions diagnosed with microsopic examination were selected,including 70 cases of cervical squamous carcinoma,50 cases of cervical carcinoma in situ（CIN Ⅲ）and 20 cases of cervicitis,and fasting venous blood was also collected and the cervical tissue for microscopic examination was obtained.The protein and mRNA expressions of p53,Fas,TNF-αand cyclin E in serum and different cervical tissues were detected by ELISA,real-time fluorescence quantitative method and immunohistochemical method;the relationships between the expressions of p53,Fas,TNF- αand cyclin E proteins and the clinical stages,pathological types and lymph node metastasis of cervical squamous cell carcinoma were analyzed.Results Compared with the patients with cervicitis,the protein and mRNA expression levels of p53,Fas,and TNF-αin serum and cervix tissue in the patients with cervical squamous cell carcinoma and cervical carcinoma in situ were decreased（P 0.01）,but the expression levels of cyclin E mRNA and protein were significantly increased（P〈0.01）,there was no statistical significance between the patients with cervical squamous cell carcinoma and the patients with cervical carcinoma in situ（P〉0.05）.The positive expression rates of p53,Fas,TNF- αand cyclin E had positive relations with the clinical stages,pathological types and lymph node metastasis of cervical squamous cell carcinoma（P〈0.01）.Conclusion The down-regulation of the expression levels of p53,Fas and TNF-αand the up-regulation of cyclin E expression level in the serum and cervix tissue of the patients with cervical squamous cell carcinoma and cervical carcinoma in situ may be associated with the tumor invasion and metastasis of cervical carcinoma,and they may

关 键 词：宫颈肿瘤 宫颈原位癌 宫颈炎 肿瘤抑制基因 细胞凋亡信号受体 肿瘤坏死因子α 细胞周期素E 

分 类 号：R711.32[医药卫生—妇产科学] R737.33[医药卫生—临床医学]