凋亡因子和凋亡抑制因子在宫颈上皮内瘤样病变及宫颈癌中的表达及意义

Expression and significance of pro-apoptotic factors and anti-apoptotic factors in cervical intraepithelial neoplasia and cervical carcinoma

目的探讨凋亡因子Cyt-c、Caspase-9、Caspase-3和凋亡抑制因子Bcl-2、Survivin在宫颈上皮内瘤样病变(cer-vical intraepithelial neoplasia,CIN)及宫颈癌中的表达,以了解它们在宫颈肿瘤发生、发展中的作用。方法采用免疫细胞化学S-P法和图像分析技术检测3种凋亡因子和2种凋亡抑制因子在已确诊的45例宫颈鳞癌、18例腺癌、33例宫颈上皮内瘤样变和23例正常对照的表达情况。结果Cyt-c在腺癌组的表达率明显高于正常组(P<0.01);CIN组及鳞癌组与正常组比较无统计学差异(P>0.05);Cyt-c在腺癌中的表达率高于CIN组和鳞癌组(P<0.05)。Caspase-9在CIN组、鳞癌组、腺癌组的表达阳性率与正常组比较无统计学差异(P>0.05),但腺癌组Caspase-9阳性表达率高于CIN组及鳞癌组(P<0.05)。Caspase-3在腺癌组的阳性表达率高于正常组(P<0.01);在鳞癌组的表达率高于正常组(P<0.05),腺癌组高于CIN组和鳞癌组(P<0.01)。Bcl-2和Survivin在腺癌组、CIN组和鳞癌组的表达率均明显高于正常组(P<0.05),并在腺癌中的表达率最高。结论凋亡因子和凋亡抑制因子的表达可能与宫颈癌的发生、发展密切相关。两者在宫颈癌的发病机制中可能共同起作用。

Objective Evidence shows that there is close relationship between apoptotic disorder with malignant changes of the cells. To study the role of apoptosis in cervical tumor, we detected the expressions of 3 pro-apoptotic factors （Cyt-c, Caspase-9 and Caspase-3） and 2 anti-apoptotic factors （Bcl-2 and survivin） in cervical intraepithelial neoplasia （CIN） and cervical carcinoma. Methods Expression of the 3 pro-apoptotic factors and anti-apoptotic factors was detected using the S-P immunocytochemical staining method and image analysis in 45 cases of pathologically identified squamous cell carcinoma （SCC）, 18 cases of adenocarcinoma （AC） , 33 cases of CIN and 23 normal subjects as control. Results Expression of Cyt-c in AC group was obviously higher than that of control （P 〈 0.01 ）, and was higher in the AC group than CIN and SCC groups （P 〈 0.05）. There was no significant difference in the expression of Cyt-c in CIN and SCC groups with that control （ P 〉 0. 05）. Comparing the expression of Caspase-9 in the normal group with the other 3 groups, there was no significant difference （ P 〉 0.05 ）. But the expression of Caspase-9 in AC group was significantly higher than that in CIN and squamous cell carcinoma group （ P 〈 0.05 ）. The expression of Caspase-3 in AC group was obviously higher than that of control （P 〈 0.01 ）. As well as that of in SCC group was higher than that of control （P 〈 0. 05）. However, that in AC group was higher than in CIN and SCC group （P 〈0.01 ）. The expression of Bcl-2 and survivin in AC group, SCC group and CIN group was obviously higher than that of control, and the expression in AC group was the highest. Conclusion Pro-apoptotic factors and anti-apoptotic factors might play important roles in the occurrence and development of cervical carcinoma.