子宫内膜癌和宫颈癌中CT抗原精子蛋白17的异常表达

Cancer-testis Antigen Sperm Protein 17 Overexpressed in Endometrial and Cervical Carcinomas

目的人精子蛋白17(spermprotein17,Sp17)正常情况下局限表达于睾丸,近年发现在上皮性卵巢癌等恶性肿瘤中异常表达,已被列入CT(cancer/testis)抗原家族。我们研究该蛋白在不同病理类型的子宫内膜癌和宫颈癌中的表达频度、分布类型以及与肿瘤临床分期分级的关系,旨在探讨Sp17是否可能成为相关妇科肿瘤诊断标志和治疗靶标。方法用免疫组化技术检测81例石蜡包埋的妇科恶性肿瘤组织标本中Sp17的表达,其中包括50例子宫内膜癌(腺癌44例、腺鳞癌6例)和31例宫颈癌(鳞癌17例、腺癌14例)。结果子宫内膜癌组织Sp17的阳性率为66%(33/50),其中腺癌29例阳性,腺鳞癌4例阳性,表达模式呈异质性,Sp17表达与肿瘤分化程度和临床分期均无相关性。宫颈癌组织Sp17总阳性率32.2%(10/31),鳞癌23.5%(4/17),腺癌42.8%(6/14)。结论Sp17在子宫内膜癌和宫颈腺癌中呈高水平异常表达,尽管其表达与肿瘤分化程度和临床分期无明显相关,仍有可能作为肿瘤体内显像诊断和免疫治疗的分子靶标。

Objective Human sperm protein 17 （Spl7） is a highly conserved protein that is expressed normally in testis. It has recently been included in the cancer/testis （CT） antigen family, and shown to be expressed in ovarian cancer, but little is known about it＇s expression in other gynecological carcinomas. The aim of this study was to investigate the frequency of Sp17 expression at protein level and its cell pattern distribution in various histological subtypes of endometrial and cervical carcinomas, and correlation between Sp17 expression and clinical characteristics, in order to establish its usefulness as a molecular marker and a target for related tumor vaccine strategies. Methods The expression of Sp17 was assessed by means of a standardized immunohistochemical （IHC） procedure in 81 formalin-fixed and paraffin embedded gynecological cancer specimens, including 50 primary endometrial cancers （44 adenocarcinomas,6 adenosquamous carcinomas） and 31 cervical carcinomas （14 adenocarcinomas, 17 squamous carcinoma）. Results Most of endometrial cancers （66%） were found heterogeneously immunopositive for Sp17. The expression pattern was heterogeneous in the positive samples, and did not correlate with the histological subtype, degree and FIGO stage of malignancy. A number of cervical carcinomas （32. 2%） were found heterogeneously immunopositive for Sp17, adenocarcinomas 42. 8% （6/14）, squamous carcinoma 23. 5 （4/17）. Conclusion Although there was no statistically significant relation between expression of Sp17 and degree and FIGO stage of malignancy, the data showed aberrant expression by IHC in a significant proportion of gynecological tumors. These findings indicate that Sp17 may be used as a marker for molecular imaging and attractive target for antigen specific immunotherapy in these patients.