宫颈鳞癌组织中促红细胞生成素及其受体蛋白表达、微血管密度变化

Expression of erythropoietin/erythropoietin-receptor and microvessel density changes in cervical squamous cell carcinoma

目的观察宫颈鳞癌组织促红细胞生成素(EPO)、促红细胞生成素受体(EPO-R)蛋白表达及微血管密度(MVD)变化,并探讨三者与宫颈鳞癌临床病理参数的关系。方法收集宫颈鳞癌组织标本76例份(观察组),宫颈高度鳞状上皮内病变(HSIL)组织标本25例份(HSIL组),宫颈低度鳞状上皮内病变(LSIL)组织标本20例份(LSIL组),正常宫颈组织标本20例份(正常组)。用免疫组化SP法检测各组宫颈组织EPO、EPO-R蛋白及CD31,根据CD31免疫组化染色结果测算MVD。比较各组EPO、EPO-R蛋白表达及MVD,分析观察组EPO、EPO-R蛋白表达及MVD与宫颈鳞癌患者年龄、肿瘤直径、组织学分级、FIGO分期、脉管腔侵犯、淋巴结转移的关系,分析观察组宫颈鳞癌组织EPO、EPO-R表达与MVD的相关性。结果观察组、HSIL组、LSIL组、正常组EPO阳性表达率分别为76.32%、52.00%、25.00%、10.00%,EPO-R阳性表达率分别为82.89%、60.00%、30.00%、15.00%,观察组与HSIL组、LSIL组、正常组相比,HSIL组与正常组相比,P均<0.05。观察组、HSIL组、LSIL组、正常组MVD分别为(45.46±5.62)、(25.64±3.80)、(12.35±2.70)、(6.90±1.62)条/5 HP,各组两两相比,P均<0.05。观察组EPO、EPO-R蛋白的表达与患者年龄、肿瘤直径、组织学分级、FIGO分期、脉管腔侵犯、淋巴结转移无关(P均>0.05);MVD与患者肿瘤直径、组织学分级、脉管腔侵犯、淋巴结转移有关(P均<0.05)。观察组MVD与EPO、EPO-R表达均呈正相关(r分别为0.623、0.575,P均<0.05)。结论宫颈鳞癌组织EPO、EPO-R蛋白表达及MVD升高,EPO、EPO-R可能通过促进肿瘤血管形成而促进宫颈鳞癌的进展。

Objective To observe the expression of erythropoietin（ EPO）/erythropoietin-receptor（ EPO-R） and measure microvessel density（ MVD） in cervical squamous cell carcinoma and to investigate the relationships of them with clinicopathological parameters. Methods Seventy-six cases of patients with cervical squamous cell carcinoma（ observation group）,25 cases of high-grade squamous intraepithelial lesion（ HSIL group）,20 cases of low-grade squamous intraepithelial lesion（ LSIL group） and 20 cases of normal cervical epithelia（ normal group） were collected. Immunohistochemical SP method was performed to detect the expression of EPO/EPO-R and CD31 expression and then we measured MVD in these specimens. The expression differences of EPO/EPO-R and MVD in these specimens were compared. In the observation group,correlations of EPO/EPO-R and MVD with patients＇ clinicopathological parameters such as age,tumor size,histological grading,FIGO staging,lymphovascular invasion and lymph node metastasis were analyzed,and correlations of EPO/EPO-R expression with MVD were also analyzed in cervical squamous cell carcinoma. Results The positive expression rates of EPO in the observation group,HSIL group,LSIL group and normal group were 76. 32%,52. 00%,25. 00%and 10. 00%,respectively; the positive expression rates of EPO-R were 82. 89%,60. 00%,30. 00% and 15. 00%,respectively. The positive expression rates of EPO and EPOR were gradually increased from normal cervix to LSIL to HSIL and then to cervical squamous cell carcinoma,and the difference was statistically significant（ all P〈0. 05）.The MVD of the observation group,HSIL group,LSIL group and normal group was（ 45. 46 ± 5. 62）,（ 25. 64 ± 3. 80）,（ 12. 35 ±2. 70） and（ 6. 90 ± 1. 62）/5HP,and significant difference was found among these groups（ all P〈0. 05）. In the observation group,EPO and EPO-R expression was not significantly correlated with age,tumor size,histological grading,FIGO staging,lymphovascular invasion and lymph node metastasis（ all P〈0. 05）. MVD was significantly correlated with tumor size,histological differentiation,lymphovascular invasion and lymph node metastasis（ all P〈0. 05）. In the observation group,MVD was positively correlated with EPO expression（ r = 0. 623,all P〈0. 05） as well as EPO-R expression（ r = 0. 575,P〈0. 05）. Conclusions EPO/EPO-R expression and MDV increase in the cervical squamous cell carcinoma tissues,and EPO and EPO-R may promote the progression of cervical squamous cell carcinoma by enhancing the cervical angiogenesis.