宫颈组织中脆性组氨酸三联体基因和凋亡抑制蛋白的表达及临床意义

Expression and clinical significance of fragile histidine triad gene and inhibitor of apoptosis protein in cervical tissue

目的研究脆性组氨酸三联体基因（FHIT）蛋白和凋亡抑制蛋白（survivin）在正常宫颈、宫颈上皮内瘤变和宫颈癌中的表达情况，探讨两者在宫颈癌早期诊断和发生发展中的临床意义。方法采用免疫组织化学sP法检测20例正常宫颈组织；20例宫颈CINI级、25例CINⅡ／Ⅲ级；60例宫颈癌组织中的FHIT蛋白和凋亡抑制蛋白的表达。结果FHIT蛋白在正常宫颈组、宫颈CIN组、CINⅠ组、CINⅡ／Ⅲ组和宫颈癌组中的阴性率分别为0％（0／20）、24．4％（11／45）、10．0％（2／20）、36．0％（9／25）和66．7％（40／60），各组间阴性率比较差异有统计学意义（P〈0．05）；凋亡抑制蛋白在正常宫颈组织、宫颈CIN组、宫颈癌组中的阳性率分别是20．0％（4／20）、31．1％（14／45）和95．0％（57／60），各组间阳性率比较差异有统计学意义（P〈0．05）；在宫颈CIN和宫颈癌中，FHIT和凋亡抑制蛋白的表达有一定的相关性（P〈0．05）。结论检测宫颈CIN中的FHIT蛋白表达情况，可用作高级别的CIN筛查或预测。FHIT和凋亡抑制蛋白对于宫颈癌前期病变和宫颈癌的筛查和早期诊断具有一定的临床参考价值。

Objective To study the expression of fragile histidine triad （FHIT） and survivin in normal cervix, cervical intraepithelial neoplasia（CIN） and cervical cancer. To discuss the potential involvement of FHIT and survivin in tumorigenesis, metastasis in cervical cancer; to discuss the significance of FHIT and survivin in early diagnosis of cervical cancer. Methods The expressions of FHIT protein and survivin were detected by immunohistochemistry in 20 cases of normal cervix,20 cases of CIN Ⅰ,25 cases of CIN Ⅱ/Ⅲ, 60 cases of cervical cancer. Results The percentages of negative expression of FHIT protein in normal tissues were 0% （0/20）, 24. 4% （ 11/45 ） in CIN group, 10.0% （2/20） in CIN Ⅰ group, 36.0% （ 9/25 ） in CIN Ⅱ /Ⅲ group and 66. 7% （40/60） in cervical cancer group. There were significant differences between groups （Chi-square test, P 〈 0. 05 ）. The positive expression rate of survivin wase 20. 0% （ 4/20 ） in normal group, 31.1% （ 14/45 ） in CIN group,and 95.0% （57/50）in cervical cancer group. There was significant difference between groups （Chisquare test, P 〈 0.05 ）. FHIT protein expression and survivin expression were negatively related （ P 〈 0.05 ） in CIN and cervical cancer. Conclusion Since the expression level of FHIT is associated with the grade of CIN, it can be used to screen or forecasting higher-grade-group of CIN. FHIT and survivin has clinical reference value for screening and early diagnosis of cervical lesions and cervical cancer.