新辅助化疗前后宫颈癌组织中张力蛋白同源基因和细胞周期蛋白E表达的临床研究

Clinical significance of the expression of PTEN and CyclinE before and after neoadjuvant chemotherapy for cervical cancer

目的探讨新辅助化疗前后宫颈癌组织中人第10号染色体缺失的磷酸酶及张力蛋白同源基因（PTEN）和细胞周期蛋白E（CyclinE）表达的临床意义。方法选择宫颈癌Ib2期和IIa2期患者50例,手术前给予紫杉醇＋顺铂（TP）方案化疗1~2个疗程,化疗前后检测宫颈癌组织中PTEN和CyclinE的表达,分析PTEN、CyclinE表达与宫颈癌组织的临床病理分级、宫颈肌层浸润深度和淋巴结转移的关系。结果化疗前,高-中分化和低分化宫颈癌组织中PTEN阳性率分别为56.7%和20.0%,差异有统计学意义（P〈0.05）;化疗后,PTEN的阳性率分别为93.3%和75.0%,差异无统计学意义（P〉0.05）。浅-中肌层和深肌层浸润宫颈癌患者化疗前PTEN阳性率分别为53.4%和27.3%,差异有统计学意义（P〈0.05）;化疗后PTEN阳性率分别为92.9%和77.3%,差异无统计学意义（P〉0.05）。淋巴结转移阴性和阳性患者化疗前PTEN阳性率分别为51.4%和20.0%,差异有统计学意义（P〈0.05）;化疗后PTEN阳性率分别为91.4%和73.3%,差异无统计学意义（P〉0.05）。高-中分化和低分化患者化疗前CyclinE的阳性率分别为60.0%和85.0%,差异有统计学意义（P〈0.05）;化疗后CyclinE阳性率分别为33.3%和25.0%,差异无统计学意义（P〉0.05）。浅-中肌层和深肌层浸润患者化疗前CyclinE阳性率分别为42.9%和86.4%,差异有统计学意义（P〈0.05）;化疗后CyclinE的阳性率分别为28.6%和31.8%,差异无统计学意义（P〉0.05）。淋巴结转移阴性和阳性患者化疗前CyclinE阳性率分别为51.4%和86.7%,差异有统计学意义（P〈0.05）;化疗后CyclinE的阳性率分别为22.9%和46.7%,差异无统计学意义（P〉0.05）。结论低分化、深肌层浸润和淋巴结转移的宫颈中PTEN低表达,化疗可明显提高PTEN的表达;相反,低分化、深肌层浸润和淋巴结转移的宫颈中CyclinE高表达,化疗可明显降低CyclinE的表达。PTEN和CyclinE表达与宫颈癌的发生、发展、转移密切相关。

Objective To explore the clinical significance of the expression of PTEN and CyclinE before and after neoadjuvant chemotherapy in cervical carcinoma. Methods A total of 50 patients with cer- vical cancer staging Ib2 and IIa2 were analyzed. TP model chemotherapy were given 1-2 cycles before sur- gery. The study aims to detect the PTEN and CyclinE that are differentially expressed before and after TP model chemotherapy, in clinical pathological grade, myometrial invasion, cervical lymph node metastasis grouping, to evaluate their clinical significance. Results In the highly-moderately and poorly differentia-tion group, the positive rate of PTEN before chemotherapy were 56. 7% and 20. 0%, after chemotherapy were 93.3% and 75.0% , the positive rate of PTEN were（P 〈0. 05） ; In the superficial and deep muscular invasion group, the positive rate of PTEN before chemotherapy were 53.4% and 27. 3%, after chemothera- py, the positive rate of PTEN were 92.9%, 77. 3% （P 〉0. 05） ; In the lymph node metastasis negative and positive group the positive rate of PTEN were 51.4% and 20. 0% before chemotherapy, and were 91.4% and 73.3 % after surgery. In the highly-moderately and poorly differentiation group, the positive rate of Cy- clinE before chemotherapy were 60.0% and 85.0%, after chemotherapy the positive rate of CyclinE were 33.3% and 25.0% （P 〈0. 05）; In the superficial and deep muscular invasion group, the positive rate of CyclinE before chemotherapy were 42.9% and 86. 4%, after chemotherapy, the positive rate of CyclinE were 28. 6%, 31.8% （P 〉 0. 05）; In the lymph node metastasis negative and positive group the positive rate of CyclinE were 51.4% and 86. 7% before chemotherapy, and were 22. 9% and 46.7 % after chemo- therapy （ P 〉 0. 05 ）. Conclusion The expression of PTEN was down-regulated and CyclinE was up-regula- ted before and after chemotherapy in the cervical cancer risk factors such as low differentiated, deep muscu- lar invasion and lymph node metastasis. Our study shows that PTEN and CyclinE is closely related to the de- velopment and metastasis of cervical cancer.