宫颈上皮内瘤变及宫颈癌中TS、PCNA的表达及其意义

Expressions and clinical significances of TS and PCNA in cervical intraepithelial neoplasia and cervical carcinoma

目的:探讨胸苷酸合成酶(thymidylate synthase,TS)在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及宫颈癌发生、发展中的作用及与预后的关系。方法:采用免疫组化SP法检测TS、增殖细胞核抗原(proliferating cell nuclearantigen,PCNA)在慢性宫颈炎、宫颈上皮内瘤变及宫颈癌中的表达。结果:与慢性宫颈炎相比,CIN及宫颈癌中TS的表达率明显增高(P值分别为0.006、0.004);而CIN与宫颈癌组比较,差异无统计学意义(P=0.780);CIN各组之间差异亦无显著性。在宫颈癌中,TS的表达与临床分期、淋巴结转移有关(P值分别为0.033、0.015),与细胞分化程度及肌层浸润深度无关(P值分别为0.343、0.350)。PCNA在CIN和宫颈癌中的表达率明显高于慢性宫颈炎(P值分别为0.029、0.000),在宫颈癌中的表达率也明显高于CIN(P值为0.000)。在CIN和宫颈癌中,TS和PCNA的表达存在关联性(Pearson列联系数=0.319 6,χ2=8.371,P<0.005)。结论:TS作为一种促细胞增殖的蛋白与宫颈病变的发生有一定关系,对预测宫颈癌的预后有一定参考价值。

Objective：To explore the role of thymidylate synthase（TS） in occurrence and development of cervical intraepithelial neoplasia（CIN） and cervical carcinoma and its relationship with prognosis. Methods：Immunohistochemical SP method was used to detect the expression levels of TS and proliferating cell nuclear antigen（PCNA） in chronic cervicitis,CIN and cervical carcinoma. Results：Compared with chronic cervicitis group,the expression rates of TS in CIN group and cervical carcinoma group increased significantly（P=0.006,0.004,respectively）.There was no significant difference in expression rate of TS between CIN group and cervical carcinoma group（P=0.780）;there was no significant difference in expression rate of TS among subgroups of CIN group;in cervical carcinoma group,the expression of TS correlated with clinical stages（P=0.033） and lymph node metastasis（P=0.015）,but it was not related to degree of cell differentiation（P=0.343） and depth of myometrial invasion（P=0.350）.The expression rates of PCNA in CIN group and cervical carcinoma group were significantly higher than that in chronic cervicitis group（P=0.029,0.000,respectively）,the expression rate of PCNA in cervical carcinoma group was also significantly higher than that in CIN group（P=0.000）;in CIN group and cervical carcinoma group,there was correlation between TS expression and PCNA expression（Pearson contingency coefficient=0.3169,χ2=8.371,P0.005）. Conclusion：As a kind of proliferating protein,TS plays an important role in the occurrence of cervical lesions,which has a certain prognostic value in cervical carcinoma.