Mdm2、PTEN表达和细菌L型感染与卵巢肿瘤的相关性研究

Correlation between ovarian tumor and the expression of PTEN,Mdm2 and L-form bacteria infection

目的探讨Mdm2癌基因、PTEN抑癌基因和细菌L型感染在卵巢肿瘤中的表达及临床意义,并分析它们之间的相互影响和协同作用。方法应用免疫组化、原位杂交和革兰染色等方法检测97例卵巢乳头状癌及23例卵巢乳头状瘤组织中Mdm2、PTEN的表达及细菌L型检出率,并用χ2检验进行统计学处理。结果卵巢恶性肿瘤中Mdm2蛋白和基因的表达率均明显高于良性肿瘤(P<0.0001～0.0005)。Mdm2蛋白和基因的表达在卵巢乳头状癌中临床分期Ⅲ、Ⅳ期的表达率明显高于Ⅰ、Ⅱ期(P<0.005);随着病理分级增高而显著增加(P<0.005);腹腔淋巴结有转移、有腹水比无转移者、无腹水者差异有显著性(P<0.01～0.05),呈正相关。PTEN蛋白及基因的表达在卵巢良性肿瘤均明显高于恶性肿瘤,病理分级Ⅰ、Ⅱ级的阳性表达率明显高于Ⅲ级;临床分期Ⅰ、Ⅱ期中的阳性表达率明显高于Ⅲ、Ⅳ期(P<0.001～0.005);腹腔淋巴结无转移者、无腹水者比有转移、有腹水差异有显著性(P<0.01～0.05),呈负相关。细菌L型检出阳性率与病理分级、临床分期差异有显著性(P<0.05),腹腔淋巴结有转移、有腹水比无转移者、无腹水者差异有非常显著性(P<0.01)。结论Mdm2、PTEN基因在卵巢肿瘤中有不同程度的异常表达,两种基因均可作为判断卵巢肿瘤生物学行为及患者预后参考指标。L型感染极有可能导致基因的变异或过表达,因此L型感染可能成为诱发肿瘤形成的原因之一。细菌L型感染可能诱导PTEN抑癌基因、Mdm2癌基因的变异和异常表达以及它们相互协同在卵巢肿瘤发生和发展过程中起重要作用。

Objective To study the expression of PTEN tumor suppressor gene, Mdm2 oncogene gene and infection caused by L-form bacteria in ovarian neoplasms and to discuss their relationship and their clinical significance, as well as to analyze the mutual influence and coordination between them. Methods Immunohistochemical staining and Hybridization in situ was used to detect the expression of Mdm2 and PTEN in 97cases ovarian papillary carcinoma and 23cases ovarian papillary epithelioma. Gram＇s straining was used to examine the positive rate of bacteria L-forms in these tissues. And χ^2 test was used in statistics of the rosults. Results The positive rate of expression of the Mdm2 protein and mRNA was obviously higher in malignant tumors than that in benign （ P 〈 0. 0001 - 0.0005 ）. The expression of Mdm2 in clinical stage of Ⅲ and Ⅳ was highet than that in stage Ⅰ and Ⅱ （ P 〈 0. 005 ）, which increased significantly along with the pathological grade getting higher （ P 〈 0. 005 ） ; and that with celiac lymph node metastasis and ascites was significantly different from that without metastasis and ascites （ P 〈 0.01 - 0.05 ） , showing a positive correlation. The expression of PTEN was higher in grade Ⅰ and Ⅱ than that in grade Ⅲ, and it was higher in clinical stage Ⅰ and Ⅱ than in stage Ⅲ and Ⅳ （ P 〈 0. 001 - 0. 005 ）. The index of positive expression of PTEN in celiac without metastasis and ascites was significantly different from that with lymph node metastasis anal ascite （ P 〈 0.01 - 0.05 ）, showing a negative correlation. The positive rate of bacteria L-forms had obvious difference with grade and clinical stage（ P 〈 0.05 ）. Positive rate of bacteria L-forms in celiac lymph node metastasis and ascites was sign ificantly different from that without metastasis and ascites（ P 〈 0. 01 ）. Conclusion Mdm2 and PTEN genes have different degrees of abnormal expression in ovarian tumors. Both of the two genes can be used as a reference indicator in identification of biological behavior and ovarian cancer prognosis. L-type infection is very likely to cause gene mutation or over-expression, thus may become one of the reasons for tumor formation. L-form bacterial infection may induce the mutation and abnormal expression of tumor suppressor gene PTEN, Mdm2 cancer gene and their mutual coordination in the development of ovarian tumors.