TGF-β和ERα与Ⅰb期-Ⅱa期宫颈上皮癌临床病理指标及预后的关系

Expression of TGF-β and ER protein in stage Ⅰb-Ⅱa cervical adenocarcinoma patients and its relationship with prognosis

目的Ⅰb-Ⅱa级别的宫颈癌发病率约占全部宫颈癌患者的60%-70%,本研究旨在探讨TGF-β和ERα与宫颈上皮癌临床病理及预后的关系。方法应用免疫组化技术对132例随访资料完整的宫颈癌标本进行TGF-β和ERα检测,同时,以20例正常宫颈组织、20例慢性宫颈炎症组织作为对照分析其表达与宫颈癌临床指标以及预后的关系。结果与正常宫颈组织以及慢性炎症宫颈组织相比,TGF-β和ERα在宫颈癌组织中表达明显上升(P<0.05)。TGF-β和ERα的表达与宫颈上皮癌的发生年龄、肿瘤直径等一般临床病理因素无相关(P>0.05),而与患者的HPV感染史、肿瘤的病理类型、组织学分级、侵袭深度、淋巴结转移、复发、转移密切相关,TGF-β和ERα双阳性表达的肿瘤复发转移率、病理学分级、淋巴结转移等明显高于阴性表达者(P<0.01);TGF-β和ERα表达在宫颈癌患者组织中明显增高(P<0.05);Cox比例风险模型多因素分析表明,TGF-β和ERα是影响宫颈癌预后的重要独立因素,TGF-β和ERα表达双阳性的宫颈癌患者预后差。结论测定TGF-β和ERα的表达对临床上Ⅰb-Ⅱa级别宫颈癌患者的诊断、预后以及指导治疗有较大的帮助。

Objective The incidence of stage Ib-IIa accounts about60%to70%of all cervical adenocarcinomapatients.Our study aims to investigate the prognostic relationship of protein estrogen receptor alpha(ERα)and transforming growth factor beta(TGF-β)in cervical adenocarcinoma patients.Methods We used immunohistochemistryto detect ERαand TGF-βin carcinomas and incisal margins of132cases with cervical adenocarcinoma,20cases with normal cervix,and20cases with chronic cervicitis.Uni-and multivariate analysis was applied toevaluate the prognostic significance of TGF-βand ERαin carcinomas.Results The results indicated that the positiveexpression of TGF-βin carcinomas was71.21%,significantly higher compared to that in thenormal cervix(35%)and chronic cervicitis(55%)(χ2=8.901,P=0.012).Similarly,the positive expression of ERαin the carcinomas was68.18%,significantly higher compared to the normal cervix(35%)and chronic cervicitis(50%)(χ2=7.693,P=0.021).Both TGF-βand ERαin the carcinomas were associated with the vaginal recurrence,infection of HPV,depth ofinfiltration,and lymphatic metastasis(P<0.05).The conjugation of TGF-βand ERαwas an independent prognosticfactor for cervical adenocarcinoma.Survival curve showed that the positive TGF-β1and ERαindicated a short lifetime of patient with cervical adenocarcinoma.Conclusions The expression of TGF-βand ERαprotein in the carcinomashad a significant prognostic value in a patient of stage Ib-IIa in cervical adenocarcinoma.