P16^(INK4A)、Brn-3a、C-myc及端粒酶在宫颈癌中的诊断价值研究

Study on P16^(INK4A),Brn-3a,C-myc and telomerase in early diagnosis of cervical carcinoma

目的探讨P16INK4A、Brn-3a及C-myc基因表达及端粒酶活性在宫颈癌诊断中的价值。方法选取2012年3月至2014年5月接受手术治疗的宫颈癌患者40例,检测宫颈癌组织中P16INK4A、Brn-3a、C-myc的表达情况及端粒酶活性水平。同时选取40例宫颈上皮内瘤样病变(CIN)组织和28例正常宫颈组织作对比。采用受试者工作特征曲线(ROC)评价组织中P16INK4A、Brn-3a、原癌基因C-myc及端粒酶活性水平在宫颈癌诊断中的价值。结果宫颈癌组织中P16INK4A、Brn-3a和Cmyc的阳性表达率分别为100.0%、95.0%和100.0%,均高于正常宫颈和CIN组织,差异有统计学意义(P<0.05);CINⅡ和CINⅢ组织的P16INK4A阳性表达率高于正常宫颈和CINⅠ组织(P<0.05);正常宫颈组织中Brn-3a和C-myc阳性表达率均为7.14%,明显低于其他组织(P<0.05);宫颈癌组织中端粒酶活性水平为(44.38±3.82)U/g,高于其余各组,差异有统计学意义(P<0.05)。Brn-3a、C-myc诊断宫颈癌的曲线下面积Az>0.8,且灵敏度和特异度均在80.0%以上,而P16INK4A及端粒酶活性水平的诊断效能相对较低,但4个指标联合检测的诊断效能获提高,灵敏度和特异度分别为89.5%和83.4,曲线下面积Az为0.879。结论宫颈癌组织中P16INK4A、Brn-3a、C-myc表达水平和端粒酶活性异常,可能与宫颈癌的发生发展有密切关系,可作为宫颈癌诊断的参考指标。

Objective To explore the value of gene expression of P16INK4A , Brn3a and Cmyc as well as the activity of telomerase in diagnosis of cervical carcinoma. Methods Cancer tissues from 40 cases of cervical cancer undergoing surgical treatment in our hospital from 2012 March to 2014 May were collected for the detection of P16INK4A , Brn3a, Cmyc and telomerase. Meanwhile, cervical tissues from 28 cases of normal cervical patients and 40 cases of cervical intraepithelial neoplasia were chosen for comparison. The receiver operating characteristic curve （ ROC） was employed to evaluate the diagnostic value of gene expression of P16INK4A , Brn3a and Cmyc as well as the activity of telomerase on cervical carcinoma. Results The positive expression rates of P16INK4A , Brn3a and Cmyc were 100. 0%, 95. 0% and 100. 0% in cervical cancer, significantly higher than those in normal cervical and CIN tissues with statistical difference （ P〈0. 05） . P16INK4A positive expression rates of CIN IIIII were higher than those of the normal cervical and CIN I tissues （ P〈0. 05） . The positive expression rates of Brn3a and Cmyc in normal cervical tissues were 7. 1%, significantly lower than those of other groups （P〈0. 05）.The level of telomerase activity in tissues from cervical cancer is （44. 38±3. 82） U/g, higher than other groups （ P〈0. 05） . Conclusion There were abnormal pattern of gene expression of P16INK4A , Brn3a and Cmyc as well as activity of telomerase, likely to be associated with the pathogenesis and development of cervical cancer. The above parameters can be taken as reference indices for the diagnose of cervical cancer.