中期因子、p63α在宫颈鳞状细胞癌组织中的表达及其意义

Expression and significance of midkine and p63α in cervical squamous cell carcinoma

目的:研究宫颈鳞状细胞癌(SCC)组织中中期因子(MK)及p63α的表达情况,分析其在宫颈SCC发生发展过程中的意义。方法:收集89例宫颈SCC病人(SCC组)及50例行子宫切除术且宫颈正常的子宫肌瘤或子宫腺肌症病人(对照组)作为研究对象。采用免疫组织化学SP法测定宫颈SCC组织及对照组正常宫颈组织中MK及p63α的表达情况。并通过查阅病例收集病人临床病理特征资料,术后通过电话或门诊复查的方式对病人的5年内生存情况进行随访。比较2组宫颈组织中MK、p63α的表达差异,采用Spearman等级相关检验分析2种蛋白的相关关系,研究MK及p63α表达对SCC病人临床病理特征及5年内生存率的影响。结果:SCC组病人MK蛋白的高表达率(29.21%)和低表达率(39.33%)显著高于对照组(2.00%和12.00%),p63α的阳性表达率(68.54%)显著低于对照组(90.00%)(P<0.01);MK表达和p63α表达呈负相关关系(P<0.01);SCC组病人不同年龄、肿瘤直径、分化程度及5年内临床结局组内的MK、p63α的表达水平差异均有统计学意义(P<0.05~P<0.01),其中,年龄≥49岁、肿瘤直径>4 cm、分化程度低的SCC病人MK的表达率显著高于其他特征组,而p63α的表达率显著低于其他特征组(P<0.05~P<0.01)。存活组中MK的表达率显著低于死亡组,p63α的表达率高于死亡组(P<0.05~P<0.01)。结论:高水平MK及低水平p63α表达可协同参与宫颈SCC的发生发展过程,影响其恶性程度及预后。

Objective:To investigate the expression levels of midkine(MK)and p63αin cervical squamous cell carcinoma(SCC)tissue,and analyze its significance in the development of cervical SCC.Methods:Eighty-nine cervical SCC patients and50leiomyoma or adenomyosis patients treated with hysterectomy were divided into the SCC group and control group,respectively.The expression levels of MK and p63αin two groups were detected using immunohistochemical SP method.The clinical pathological feature in SCC group was collected,and the5-year survival in SCC group was followed up by telephone or outpatient review.The levels of MK and p63αin cervical tissues between two groups were compared.The correlation between two proteins was analyzed using Spearman rank correlation test.The effects of MK and p63αon the clinicopathological features and5-year survival in SCC group were investigated.Results:The high expression rate of MK(29.21%)and low expression rate of MK(39.33%)in SCC group were significantly higher than that in control group(2.00%and12.00%)(P<0.01),the positive expression rate of p63αin SCC group(68.54%)was significantly lower than that in control group(90.00%)(P<0.01),and the expression of MK was negatively correlated with p63α(P<0.05).The differences of the expression levels of MK and p63αin different age,tumor size,differentiation degree and5-year survival in SCC group were statistically significant(P<0.05to P<0.01).The expression rates of MK and p63αin patients with age≥49years old,tumor size>4cm and low differentiation were significantly higher and lower than those in other features patients in SCC group,respectively(P<0.05to P<0.01).The expression rates of MK and p63αin survival patients were significantly lower and higher than those in death patients,respectively(P<0.05to P<0.01).Conclusions:High expression level of MK and low expression level of p63αcan be involved in the pathogenesis and development of cervical SCC,and affect the degree of malignancy and prognosis.