Maspin蛋白和p53蛋白在宫颈鳞癌中的表达及与乳头瘤病毒感染的相关性研究

Expression of maspin protein in cervical squamons carcinoma and its relationship with p53 expression and HPV infection

目的研究maspin蛋白及p53蛋自在宫颈鳞癌及宫颈上皮内瘤样变组织中的表达及与高危型人乳头瘤病毒（HPV）感染的相关性。方法应用免疫组化sP法检测maspin蛋白和p53蛋白在宫颈鳞癌、宫颈上皮内瘤样变、正常宫颈3种组织中的表达。分析maspin蛋白表达与宫颈鳞癌各临床病理参数之间的关系，以及宫颈鳞癌组织中maspin蛋白与p53蛋白表达的相关性。HPV检测采用PCR扩增．导流杂交的方法进行分型检测，并将高危性感染率与maspin表达率进行相关性分析。结果（1）从正常宫颈上皮组织→宫颈上皮内瘤样变→宫颈鳞癌maspin蛋白表达逐渐下调，三者比较差异有统计学意义（P〈0．05）；（2）临床分期越高，分化程度越低的宫颈鳞癌组织中，maspin阳性表达越少。有淋巴结转移的宫颈鳞癌中，maspin阳性率低于无淋巴结转移者，2者比较差异有统计学意义（P〈0．05）；（3）maspin蛋白与p53蛋白在宫颈鳞癌组织中的表达呈负相关（rs=-0．399，P〈0．01）；（4）maspin蛋白的表达与高危型HPV感染呈负相关（rs=-0．294，P〈0．01）。结论maspin蛋白在宫颈鳞癌的发生发展过程中起重要的抑制作用，可作为判断宫颈鳞癌患者病情进展及预后的指标之一。maspin蛋白在高危性HPV感染后可能受p53等因子的调控表达下调，可用于宫颈癌的基因治疗研究。

Objective To investigate expression of maspin protein in cervical squamous carcinoma （CSC） and evaluate its possible role in tumorigenesis and progression of cervical carcinoma, and to further investigate its relationship between p53 expression and HPV infection. Methods Levels of maspin protein and p53 protein in cervical squamous carcinoma, cervical intraepithelial neoplasia and normal uterine neck were detected by immunohistochemistry. Analyses were made concerning possible relationship between the expression of 2 proteins and clinicopathologic indices and correlation between maspin in CSC and p53 expression. HPV detection was made with PCR amplification and hybridization. Results （ 1 ） Expression of maspin in squamous cell carcinoma of the cervix gradually down-regulated, as seen from normal cervical tissue to cervical intraepithelial neoplasia to squamous cell carcinoma of the cervix with statistical significance （ P 〈 0.05 ）. The higher the clinical stages and the lower the cell differentiation, less expression of maspin there was. In cervical squamous carcinoma with lymphatic metastasis, positive expression rate of maspin was lower than that without lymphatic metastasis. And significant differences could be noted when comparisons were made between the two （P 〈0.05 ）. Negative correlation could be seen between expressions of maspin and p53 in cervical squamous carcinoma（ rs =-0. 399 ,P 〈 0.05 ）. （2）Negative correlation was shown between expressions of maspin and the high-risk HPV infection（ rs = - 0.294, P 〈 0.05 ）. Conclusions Maspin might play a strong inhibitory role in the genesis and development of squamous cell carcinoma of the cervix. Abnormal expression of maspin might have an inhibitory effect on the invasion and metastasis of cervical carcinoma and could be used as an objective marker for the development and prognosis of cervical squamous carcinoma. Due to p53, expression of maspin might down - regulated following high-risk HPV infection and might be used in the research of gene therapy for cervical carcinoma.