c-erbB-2和EGFR在外阴白色病变中的表达

Expression of c-erbB-2 and EGFR in Vulvar White Lesions and Its Significance

目的检测外阴白色病变组织中c-erbB-2和EGFR的表达,探讨其在该病发病机制中的作用及相互关系。方法采用免疫组织化学方法检测39例患者的外阴白色病变其中硬化性苔癣(LS)11例,鳞状上皮细胞增生(SH)19例,SH合并LS9例,并以此分组。组织中c-erbB-2、EGFR的表达情况。以11例正常外阴皮肤石蜡包埋组织作为对照组。结果EGFR基因蛋白在对照组与SH组、LS合并SH组间的表达差异有统计学意义(χ2=8.56,P<0.05),SH组与其他各组间差异有统计学意义(χ2=7.79,P<0.01),LS组与对照组及LS合并SH组间差异无统计学意义(χ2=1.23,P>0.05)。在对照组与LSH组和LS合并SH组间c-erbB-2基因蛋白表达差异有统计学意义(χ2=11.40,P<0.01)。EGFR基因蛋白阳性表达产物位于表皮基底层和棘层,主要位于细胞膜,部分位于细胞质内,而c-erbB-2基因蛋白阳性表达产物位于表皮基底层?颗粒层和棘层上部,主要位于细胞膜,部分位于细胞质内。在外阴白色病变患者中,c-erbB-2与EGFR的表达有相关性(r=0.388,P=0.015)。结论c-erbB-2、EGFR的过度表达可能与外阴鳞状上皮细胞增生的发生有关,也可能是外阴鳞状上皮细胞增生较硬化性苔藓易于癌变的原因之一。c-erbB-2、EGFR基因表达有相关性。c-erbB-2、EGFR在SH组中的过度表达使基于二者的免疫靶向治疗成为可能。

Objective To investigate the relationship and significance of c-erbB-2 and EGFR in vulvar white lesions. Methods Biopsies from 39 patients with vulvar white lesions（ 11 cases with lichen sclerosus, 19 cases with squamous hyperplasia, 9 cases with SH and LS） were examined for expression of c-erbB-2 and EGFR using immunohistochemical techniques. The average age of 39 patients with vulvar white lesion was 47.0 （26 ～ 72） years. Normal vulvar skin from 11 patients with other benign gynecologic diseases with average age of 46.1 （32 ～ 68 ） years were used as control. One thousand cells in 4 high power field were examined for each sample. A semiquantitative analysis was made on the basis of number of positive cells and staining intensity ： negative 0 ～ 3 ; positive 4 ～ 7. Results There was significant difference of expression of EGFR among four groups（χ^2 = 8.56, P 〈 0.05）, and significant difference between the tissues with SH and without （χ^2 = 7.79, P 〈 0.01 ）. However, no difference was observed between the tissues with LS and without（χ^2 = 1.23, P 〉 0.05 ） ; there was significant difference of expression of c-erbB-2 among four groups （χ^2 = 11.40, P 〉 0.01 ）, and significant difference between the tissues with SH and without （χ^2 = 10.63, P 〈 0.01 ）. However, no difference was observed between the tissues with LS and without （χ^2 = 1.26, P 〉 0.05 ） ; EGFR expression located in cell membrane and cytoplasm, and it distributed in basal cell layer and stratum spinosum, c-erbB-2 expression located in cell membrane and cytoplasm, and it distributed in basal cell layer, stratum granulosum and stratum spionsum. Significant association between c-erbB-2 and EGFR expression in vulvar white lesions was demonstrated （r =0.388, P = 0. 015 ）. Conclusion The over-expression of c-erbB-2 and EGFR in squamous hyperplasia may be related to the pathogen of squamous hyperplasia and it may be the cause why squamous hyperplasia is more liable to develop into squamous cell carcinoma of the vulva than lichen sclerosus. Significant association between c-erbB-2 and EGFR expressions in vulvar white lesions has been demonstrated. The over-expressions of c-erbB-2 and EGFR in SH make it possible that the molecular target therapy would be used in this disease in the future.