不同程度宫颈病变组织中端粒酶催化亚单位的表达与临床病理特征的关系

Expression and clinicopathologic features of human telomerase reverse transcriptase in different cervical lesions

目的:探讨端粒酶催化亚单位(hTERT)在不同程度宫颈病变组织中的表达及其与临床病理特征的关系。方法:收集不同程度宫颈病变石蜡组织标本共236例,其中宫颈炎41例、CINⅠ级45例、CINⅡ级42例、CINⅢ级41例、宫颈鳞状细胞癌39例、腺癌28例。采用免疫组化SP法检测不同程度宫颈病变组织中hTERT蛋白表达,并将结果与患者临床病理特征结合分析,探讨hTERT表达与临床病理特征的关系。结果:在宫颈炎、CINⅠ、CINⅡ、CINⅢ、宫颈鳞状细胞癌、腺癌组织中hTERT表达阳性率分别为0.00%(0/41)、2.22%(1/45)、7.14%(3/42)、39.02%(16/41)、92.31%(36/39)、92.86%(26/28),组间比较差异有统计学意义(P<0.05),CINⅠ与CINⅡ之间hTERT表达阳性率不存在统计学差异(P>0.05),而CINⅠ与CINⅢ、CINⅡ与CINⅢ之间hTERT表达阳性率存在统计学差异(P<0.05);鳞癌、腺癌组中高、中、低分化三组间hTERT表达阳性率差异均无统计学意义(P>0.05)。hTERT蛋白的表达与高危型HPV感染、宫颈肿瘤家族史呈正相关(P<0.05),但与年龄、性生活开始年龄、性伴侣人数、人工流产次数、吸烟、避孕方法选择等高危因素无相关性(P>0.05)。结论:hTERT表达的检测有可能成为宫颈病变发展及宫颈癌的诊断及鉴别诊断的一种新指标,但不一定参与肿瘤分化和生物学特性。

Objective： To investigate the expression of human telomerase reverse transcriptase （hTERT） and its relationship with the elinicopathologie features in a spectrum of cervical lesions. Methods： A total of 236 formalin - fixed, para~＇in - embedded （ FFPE ） specimens from women with different cervical diseases ： cervieitis, various grades of dysplasia （ cervical intraepithelial neoplasia grade I ~ 11[ ）, and cancer （ squamous cell carcinoma, adenoeareinoma） were enrolled for presence of HPV DNA. The expression of hTERT was de- tected by immunohistochemical method. Correlation between hTERT expression and elinieopathologic features was analyzed. Results： The positive rate of hTERT expression in cervicitis, CIN I , CIN ]I , CIN 111, squamous cell carcinoma and adenocarcinoma was 0. 00% （0/ 41）, 2.22% （1/45）., 7. 14% （3/42）, 39.02% （16/41）, 92.31% （36/39）and92.86% （26/28）respectively. Therewas also sig- nificant difference among them （ P 〈 0. 05 ） . The staining level of hTERT in cervical cancer was significantly higher than that of cervicitis and various grades of dysplasia （ P 〈 0.05 ） . There was also significant difference between CIN ] and CIN ]] - 111 （ P 〈 0. 05 ） . There was no significant association between hTERT expression in cerGcitis and various grades of dysplasia, or cervical cancer related to clinicopatho- logic parameters including age, number of abortions, exposure to smoke or second hand smoke, number of sexual partners, age of sexual be- havior beginning, and contraceptive methods （ P 〉 0.05 ）, but associations with HPV and family history of cervical cancer were found （ P 〈 0. 05 ） . Conclusion： The expression of hTERT mRNA and hTERT may use the aggressiveness of the cervical lesions as a marker, but it is not related to clinicopathologic data.