hMSH2、PCNA蛋白和金葡菌L型感染在卵巢肿瘤中的临床意义

The clinical significance of hMSH2,PCNA proteins and Staphylococcus aureus L-forms infection in ovarian tumors

目的探讨hMSH2(human mut shomolog 2)基因、增殖细胞核抗原(proliferating cell nuclear antigen,PC-NA)和金葡菌L型感染在卵巢肿瘤中的表达及临床意义。方法用免疫组化法检测97例卵巢乳头状癌及23例卵巢乳头状瘤组织中hMSH2、PCNA蛋白以及金葡菌L型抗原的表达,用革兰染色法检测这些组织中有无L型细菌的存在,并用χ2检验进行统计学处理。结果 hMSH2蛋白在卵巢恶性肿瘤组织中的阳性表达率明显低于良性肿瘤的(P<0.01),在卵巢乳头状癌中临床分期Ⅰ、Ⅱ期表达率明显高于Ⅲ、Ⅳ期(P<0.01),随着病理分级增高而显著降低(P<0.05),腹腔淋巴结无转移者、无腹水者比有转移、有腹水者明显增高(P<0.01～0.05)。而PCNA蛋白在卵巢恶性肿瘤组织中的阳性表达率明显高于良性肿瘤的(P<0.01),在卵巢乳头状癌中临床分期Ⅲ、Ⅳ期的表达明显高于Ⅰ、Ⅱ期(P<0.05),随着病理分级增高而显著增加(P<0.05),腹腔淋巴结有转移者比无转移者明显增高(P<0.05),有无腹水者之间差异无统计学意义(P>0.05)。金葡菌L型抗原阳性表达和L型菌的检出率与病理分级、临床分期有明显相关性(P<0.05),有腹腔淋巴结转移、有腹水者均高于无转移和无腹水者(P<0.01)。结论 hMSH2、PCNA蛋白在卵巢肿瘤中有不同程度的异常表达,均可作为判断卵巢肿瘤生物学行为及患者预后的参考指标,金葡菌L型的感染极有可能导致基因的突变或过表达,因此L型感染可能成为诱发肿瘤形成的原因之一,它们相互协同在卵巢肿瘤发生和发展过程中起重要作用。

Objective To explore the expression and clinical significance of hMSH2, PCNA proteins and Staphylococ- cus aureus L-forms infection in ovarian tumors. Method The expression levels of hMSH2, PCNA proteins and Staphylococcus aureus L-forms infection in 97 cases of ovarian papillary carcinoma and 23 cases of ovarian papilloma were detected respectively by immunohistochemistryi Gram staining was used to detect L-form bacteria existed in these tissues. Result The positive ex- pression rate of hMSH2 protein were lower significantly in ovarian cancer tissue than that in benign tumors （P 〈 0.01 ）, and was higher in clinical stages I ＆ II than that in the III ＆ IV stages in ovarian papillary carcinoma （P 〈 O. O1 ） ; and the expression was significantly lower with the pathological grade increased （ P 〈 0.05 ）. The positive rate in patients without celiac lymph node metastasis and ascites was significantly higher than in those with metastasis and ascites （ P 〈 0.014）. 05 ） . The expression of PCNA protein in ovarian cancer tissue was significantly higher than in benign tumors （P 〈 0.01 ） , and significantly higher in clinical stages III＆ IV than in the stages I ＆ II in ovarian papillary carcinoma （ P 〈 0.05 ）, with a significant increase as the histological grade went higher （ P 〈 0.05 ） ; The expression in the patients with celiac lymph node metastasis was significantly higher than those without metastasis （ P 〈 0.05 ）, but there was no significant difference between the patients with and without ascites （P 〉 O. 05 ）. The positive expression rate of Staphylococcus aureus antigen and the detection rate of L-forms bacteria were significantly correlated with the pathological grade and clinical stage （ P 〈 0.05 ）, and were significant higher in patients with celiac lymph node metastasis and ascites than in those without metastasis and ascites （ P 〈 0.01 ）. Conclusion hMSH2 and PCNA proteins have positive expression with certain degree in ovarian tumors. Both markers can be used to assess the bio- logical behavior of tumors and prognosis for patients. Infection of bacterial L-forms can probably result in the mutation and hyper-expression of genes, which was one of the inductive factors of the oncogenesis. They play synergistically an important role in the course of development of ovarian tumors.