宫颈鳞状细胞癌发生和演进中Maspin表达及其意义的研究

Expression and significance of maspin in carcinogenesis and progression of cervical carcinoma

目的:观察肿瘤转移抑制基因Maspin(mammary-serpin)在宫颈鳞状细胞癌和癌前病变组织中的表达,探讨其在宫颈鳞癌发生、演进中的作用及其意义。方法:运用免疫组织化学Envision二步法检测Maspin在正常宫颈组织、宫颈上皮内瘤变(CIN)和宫颈鳞癌组织的表达情况,进行统计学分析,并比较与宫颈鳞癌临床病理特征的关系。结果:Maspin在正常宫颈组织、CIN和宫颈鳞癌中阳性表达率分别为100.0%、87.5%、50.0%,表达呈逐级下降,宫颈鳞癌与前两者间差异有统计学意义,P<0.01。正常宫颈组织和CIN以细胞质表达为主,宫颈鳞癌以胞核、胞质表达为主,在部分高级别CIN和微小浸润性宫颈癌表达呈异质性,基底区和浸润灶组织阳性信号减弱或缺失。Maspin的表达与宫颈癌的临床分期,肿瘤浸润深度、淋巴结转移及患者的生存时间呈负相关。结论:Maspin表达的下调可能在宫颈鳞癌的发生和演进过程中起一定作用,是观察宫颈CIN进展的一种潜在的有用标志,并与宫颈鳞癌浸润转移和生存密切相关,有望作为判断宫颈癌预后有价值的生物学指标。

OBJECTIVE：To ivestigate the expression of maspin in cervical squamous cell carcinoma（CSCC） and cervical intraepithelial neoplasia（CIN） and its significance in carcinogenesis and progression of CSCC. METHODS： The expressions of maspin in normal cervical tissue, CIN and CSCC were examined by the Envision two-step immunohistochemical staining, and the relationship between the expression of maspin and patients clinicopathological parameters was investigated. RESULTS：The positive rates of maspin expression in normal cervical tissue, CIN and CSCC were 100.0%, 87.5%, 50.0%, respectively. The prevalence and intensity of maspin expression in CSCC were significantly higher than those in normal control and CIN（P〈0.01）. The maspin staining in normal tissue and CIN was detected in cytoplasm mainly, but it located in both cytoplasm and nucleus in CSCC. In part of high grade CIN and microinvasion CSCC, the level of maspin expression in basal lines or region of microinvasion wes lower or absent. The data also showed the negtive correlation between the expression of maspin and clinical stage, depth of invasion, lymphoid node metastasis and survival time respectively. CONCLUSIONS： Maspin maybe play an important role in carcinogenesis and progression of CSCC, and its expression might be a useful marker for diagnosis of CSCC. Maspin is associated with metastasis and survival rate of CSCC and the detection of maspin may be useful for determining the prognosis of CSCC.