宫颈癌和宫颈上皮内瘤变中表皮生长因子受体表达与人乳头瘤病毒16和(或)18感染及其相互关系

Expression of epidermal growth factor receptor and the correlation with HPV16/18 infection in cervical intraepithelial neoplasia and cervical carcinoma

目的探讨宫颈癌发生发展过程中,表皮生长因子受体(EGFR)与人乳头瘤病毒(HPV)的作用及其相互关系。方法宫颈癌组60例,选自1997年至2001年间中山大学肿瘤防治中心住院初治的宫颈癌病例,临床分期Ⅰa～Ⅱb期;宫颈上皮内瘤变(CIN)组40例;正常上皮对照组30例。以免疫组化S-P法检测宫颈组织EGFR的表达,以PCR检测HPV16和(或)HPV18感染。结果正常上皮组、CIN组和宫颈癌组的EGFR中强表达率呈梯度上升,分别为0、42.5%和76.7%,差异有统计学意义(P<0.05)。正常上皮组、CIN组和宫颈癌组的HPV16和(或)HPV18感染率分别为6.7%、67.5%和58.3%,宫颈癌组和CIN组的感染率均显著高于正常上皮组(P=0.000),但宫颈癌组与CIN组之间,差异无统计学意义(P=0.355)。肿瘤侵袭程度超过宫颈1/2间质者,EGFR中强表达率显著高于未达1/2间质者(89.2%:56.5%,P=0.004)。宫颈管侵袭者HPV16和(或)HPV18感染率显著高于无侵袭者(88.2%:46.5%,P=0.003)。EGFR与HPV之间无显著相关性(P>0.05)。EGFR与HPV均未显示与宫颈癌预后有关。结论EGFR和HPV与宫颈癌的发生发展有关;EGFR、HPV16和(或)HPV18与宫颈癌预后无关,EGFR与HPV16和(或)HPV18无显著相关性。

Objective The aim of this study was to elucidate the role of EGFR expression and HPV infection and their relationship in the genesis and progression of cervical carcinoma. Methods This analysis included 60 cases of cervical carcinoma, 40 cases of CIN and 30 cases of control group. Patients of cervical carcinoma group were all subjected to radical hysterectomy with bilateral pelvic lymphadenectomy in Tumour Hospital,Zhongshan University from 1997 to 2001. The FIGO stage was Ⅰ a -Ⅱ b. EGFR protein was stained by S-P immunohistochemistry, and HPV16/18 DNA was detected by PCR. Results The moderate/ strong expression of EGFR was observed in 0, 42.5%, 76.7% of normal cervical epithelium, CIN and cervical tumor tissue, respectively, with a significant difference among them （P 〈 0. 05）. The infection of HPV16/18 was observed in 6.7%, 67.5%, 58.3% of normal cervical tissue, CIN and cervical tumors, respectively. The infection rate of CIN or cervical carcinoma was significantly higher than that in normal cervical tissue （ P = 0. 000 ）, but no statistically significant difference was observed between cervical carcinoma and CIN. The moderate/strong expression of EGFR demonstrated an association with the cervical invasion depth. The EGFR expression increased significantly as the invasion depth progressed from less than or equal to a half cervical stroma to deeper than that （89.2% vs. 56.5% , P =0. 004）. The infection of HPV16/18 demonstrated a correlation with the cervical canal invasion. The infection increased significantly in the cases with cervical invasion than that in the cases without invasion （88.2% vs. 46.5%, P = 0. 003）. But no significant correlation was observed between EGFR and HPV. Neither EGFR nor HPV had a significant association with carcinoma prognosis. Conclusion EGFR and HPV demonstrate a significant correlation with genesis and progression of cervical carcinoma. In our study, neither EGFR nor HPVdemonstrates a significant association with tumor prognosis, and no significant correlation is observed between EGFR and HPV.