脆性组氨酸三联体基因和p53在宫颈浸润癌和癌前病变组织中的表达及意义

The expression and significance of fragial histamine triplet gene and p53 in cervical infiltrative carcinoma and cervical intraneoplasm

目的探讨脆性组氨酸三联体基因(FHIT)表达缺失或下降和p53的过度表达在宫颈癌发生发展中的意义。方法2001年1月至2003年1月温州医学院附属第一医院采用免疫组化SP法检测52例宫颈上皮内瘤样病变(CIN)和69例宫颈浸润癌组织中的FHIT基因和p53的表达,并以18例慢性宫颈炎组织为对照。结果FHIT在慢性宫颈炎组织中呈100%表达。在宫颈CINⅠ、Ⅱ、Ⅲ的下降或缺失率分别占9.1%、29.4%和41.7%。在宫颈浸润癌中的下降或缺失率占66.7%,其中鳞癌低表达率为75.4%,较腺癌的25.0%差异有显著性意义(P<0.01),临床Ⅰ、Ⅱ期和Ⅲ或Ⅳ期的缺失率分别为60.7%、65.2%和77.8%,组织学分级G1、G2和G3的缺失率分别为47.4%、64.3%和86.4%,临床Ⅰ、Ⅱ期与Ⅲ或Ⅳ期比较,组织学分级G1及G2与G3比较差异均有显著性意义(P<0.05)。p53在慢性宫颈炎组织无表达,在宫颈浸润癌中呈56.5%阳性表达,且随着临床期别的增高、细胞分化的降低以及淋巴转移的出现进一步上升。p53阳性的宫颈癌中FHIT缺失为74.4%,而p53阴性的FHIT缺失占56.7%,两者比较差异无显著性意义(P>0.05)。结论FHIT基因下降或缺失与p53过度表达是宫颈癌的频发事件,测定宫颈CIN中FHIT可作为宫颈癌的高危人群筛选指标,FHIT与p53检测还可作为宫颈癌的预后指标。

Objective To discuss the significance of the lost or decreasing expression of fragial hist amine tri plet gene (FHIT) and hyper-expression of p53 in progressing of cervical carcino ma. Methods 52 cases of cervical intraneoplasm (CIN)and 69 cases of cervical infiltrative ca rcinoma in the First Affiliated Hospital of Wenzhou Medical College from January 2001 to January 2003 were studied.18 cases of chronic cervicitis tissue served as control.The FHIT gene and p53 were evaluated by SP method. Results FHIT gene expressed in all of the chronic cervicitis tissue (100%).The decreasin g or lost rate was 9.1%,29.4% and 41.7% in CINⅠ,CINⅡ and CINⅢ,while it was 66^7% in infiltrative cervical carci noma.The decreasing expression rate in squamous carcinoma was 75^4%,which was o bviously different from that in adenocarcinoma(25^0%)(P<0.05).The rate of lost was 60.7%,65.2% and 77^8% respectively in clinical grade Ⅰ,Ⅱ and Ⅲ/ Ⅳ;the lost rate was 47.4%,64.3% and 86.4% in histologic grade G_1,G_2 and G_3. The lost rate in grade Ⅰ/Ⅱ compared with that in Ⅲ/Ⅳ,G_1/G_2 compared with G_3,was significantly different(P<0.05).The lost rate showed no diffe rence in the tumor with different sizes(≥4cm or <4cm) and metastasis of lymph n o des or not.There was no expression of p53 in chronic cervicitis.56.6% infiltrat ive cervical carcinoma showed p53 positive expression.And the expression increas ed with the increasing of clinical grade,decreasing of cell differentiation and lymph nodes metastasis.In p53 positive cervical carcinoma,the lo st rate of FHIT was 74.4%,while in negative cases,it was 56.7%.The diffe rence was not apparent (P>0.05). Conclusion Decreasing or lost of FHIT gene and hyper-expression of p53 are common in cervi cal carcinoma.FHIT and p53 can be used as the prognostic markers of cervical carcin oma,and FHIT in CIN may be used to identify the high risk people.