在子宫颈上皮内瘤变和鳞癌组织中CyclinE、Rb基因表达的研究

A STUDY OF CYCLIN E AND Rb GENE EXPRESSIONS IN CERVICAL CARCINOMA AND CERVICAL INTRAEPITHELIAL NEOPLASM

目的探讨细胞周期素E(CyclinE)、视网膜母细胞瘤(Rb)基因与上皮内瘤变(CIN)和宫颈鳞癌的关系,及其在癌变过程中的意义。方法应用免疫组化技术(S-P法),检测CyclinE和Rb基因产物在各级别CIN 77例和宫颈鳞癌40例中的表达状况,并以正常子宫颈鳞状上皮20例做对照。结果在正常宫颈鳞状上皮、CINⅠ、CINⅡ、CINⅢ及宫颈鳞癌中,CyclinE的阳性表达率呈逐渐增强趋势,分别为:0.0%、30.0%、75.0%、65.0%、60.0%。正常宫颈鳞状上皮与各级别CIN和宫颈鳞癌之间差异均有显著性(P<0.01或<0.005),CINⅠ与CINⅡ、CINⅢ、宫颈鳞癌组间差异均有显著性(P<0.005或<0.01);Rb基因蛋白的表达率逐渐下调,分别为:100.0%、55.0%、20.0%、24.3%、23.5%,在正常宫颈鳞状上皮与各级别CIN和宫颈鳞癌组间差异均有显著性(P<0.005);CINⅠ与CINⅢ、宫颈鳞癌组间差异有显著性(P<0.005)。结论Cyclin E在正常子宫颈鳞状上皮表达阴性,随着发生CIN从轻到重至宫颈鳞癌,表达呈逐渐增强趋势;表明Cyclin E在子宫颈癌变过程中起到重要作用,Cyclin E参与CIN的进展及子宫颈癌癌变机制。Rb基因蛋白在正常子宫颈鳞状上皮100%阳性,随着发生CIN从轻到重至宫颈鳞癌,表达呈逐渐下调趋势,甚至消失;表明Rb基因可能主要通过功能性失活参与宫颈鳞癌的发生,并且其在癌变过程中起重要作用。发现Cyclin E表达增强和RB基因表达下调或消失,有助于宫颈鳞癌发生的判断及CIN程度和级别的确定。

Objective To investigate the expression of cyclin E and retinoblastoma gene in cervical carcinoma and CIN, and to explore the significance of their expression in the carcinogenesis of cervical carcinoma. Methods Cyclin E and Rb gene were studied with immunohistochemical staining （S-P） in 77 cases of CIN, 40 cases of cervical invasive squamous cell carcinoma, and 20 cases of normal cervical epithelia. Results The positive rate of cyclin E increased from normal cervical epithelia, CINⅠ , CIN Ⅱ, CIN Ⅲ to cervical squamous cell carcinoma groups, being 0. 0%, 30. 0%, 75.0%, 65.0%, and 60. 0% respectively. The expression of cyclin E in the carcinoma and CIN （including CINⅠ , CIN Ⅱ, CINⅢ） was significantly higher than in normal cervical epithelia （P〈0.01 or P〈0. 005） ; CIN Ⅱ, CIN Ⅲ and cervical squamous cell carcinoma higher than CIN Ⅰ （P〈0. 005 or P〈0. 01）. The positive rate of Rb gene decreased from normal cervical epithelia, CIN to the carcinoma, being 100.0%, 60. 0%, 20.0%, 24.3% and 23. 5% respectively. There were significant differences between normal cervical epithelia and CIN or carcinoma （P〈 0. 005）, and betweon CIN Ⅰ and carcinoma or CIN Ⅲ （P〈0. 005）. Conclusion No expression of cyclin E was found in normal cervical epithelia, and the positive rate of cyclin E increased from CIN to cervical invasive squamous cell carcinoma, which indicates that the over-expression of cyclin E plays an important role in the carcinogenesis of cervical carcinoma. All 20 cases of normal cervical epithelia expressed Rb gene protein, but its expression decreased form normal cervical epithelia, CIN to cervical invasive carcinoma. The functional deactivation of Rb gene is involved in the carcinogenesis of cervical carcinoma and plays an important role. Probably, those actions take place at the early stage of the cervical carcinoma. Therefore to detect the over-expression of cyclin E and the weak expression of Rb gene is significant for the diagnosis of CIN and cervical carcinoma.