ER Bcl-2在宫颈病变发生中的相关性研究

Correlation of ER with Bcl-2 in cervical cancer and pre-cancerous lesion

目的：探讨ER、Bcl-2蛋白在不同程度宫颈病变中的相关性及意义。方法：免疫组织化学检测慢性宫颈炎20例、低度宫颈上皮内瘤变30例、高度宫颈上皮内瘤变70例及80例宫颈癌组织中ER和Bcl-2蛋白的表达。结果：ER在慢性宫颈炎组中阳性率为75%，随着宫颈病变程度的加重，其表达率逐渐降低（χ2=24.266，P〈0.01），与慢性宫颈炎组比较，CINⅡ～Ⅲ组和宫颈鳞癌组差异有统计学意义，CINⅠ组差异无统计学意义（χ2=0.751，P=0.386）。与肿瘤组织类型及病理分级无关；BCL-2在宫颈鳞癌组中阳性率为75.38%，随着宫颈病变程度的加重，其表达率逐渐增高（χ2=27.715，P〈0.01），与慢性宫颈炎组比较，CINⅠ组、CINⅡ～Ⅲ组及宫颈鳞癌组差异均有统计学意义。与宫颈鳞癌病理分级相关（χ2=4.862，P=0.027），与肿瘤组织类型无关（P=0.500）；CINⅡ～Ⅲ组中联合表达阳性率为38.57%（27/70），宫颈鳞癌组中联合表达阳性率为15.38%（10/65），差异具有统计学意义（χ2=9.108， P=0.003）。CINⅡ～Ⅲ组中ER与Bcl-2蛋白表达存在相关（r=0.506，P〈0.01），其余组中无相关关系。结论：在宫颈病变的进展中， ER和Bcl-2表达呈相反趋势，在CINⅡ～Ⅲ组中有相关性，联合表达阳性可能是宫颈高度上皮内瘤变发生的主要机制之一。

Objective：This study aimed to investigate the relationship between estrogen receptor （ER） and Bcl-2 in cervical can-cer and precancerous lesions. Methods：ER and Bcl-2 were evaluated by immunohistochemistry in 20 non-tumor tissues, 30 low-grade cervical intraepithelial neoplasias, 70 high-grade cervical intraepithelial neoplasias, and 80 cervical cancers. Results：The positive rate of ER was 75%in non-tumor tissues;this rate decreased with disease severity （χ2=24.266, P〈0.01）. The overexpression of ER protein was remarkably lower in cervical intraepithelial neoplasias （CIN） Ⅱ-Ⅲ and carcinomas than in non-tumorous cervices. Differences were not significant between CINⅠand non-tumorous cervices （χ2=0.751, P=0.386）. Furthermore, ER expression was not correlated with histological type and tumor grade. The positive rate of Bcl-2 was 75.38%in squamous cell carcinoma. This rate increased with dis-ease severity （χ2=27.715, P〈0.01）. The Bcl-2 protein overexpression was remarkably higher in CINⅠ, CINⅡ-Ⅲ, and carcinomas than in non-tumorous cervices. Bcl-2 expression was also not correlated with histological type （P=0.500）;by comparison, Bcl-2 expression was correlated with tumor pathological grade （χ2=4.862, P=0.027）. The co-expression of ER and Bcl-2 was 38.57%and 15.38%in CINⅡ-Ⅲand squamous cell carcinoma, respectively;the differences between these two values were significant （χ2=9.108, P=0.003）. A cor-relation between ER and Bcl-2 was observed in CINⅡ-Ⅲ（r=0.506, P〈0.01）;no correlation was observed between other groups. Con-clusion： ER expression was inversely correlated with Bcl-2 in cervical cancer progression. The co-expression of these markers may have an important function in the course of high-grade cervical intraepithelial neoplasia.