pax1蛋白在子宫颈癌中的表达及与预后的关系

Expression of Pax1 Protein in Cervical Cancer and its Relationship with Prognosis

目的:研究配对盒基因1(pax1)在子宫颈组织中的蛋白表达及其临床意义,探讨pax1蛋白与子宫颈癌预后的关系。方法:采用免疫组化法检测中日友好医院2011年8月至2017年10月收治的101例子宫颈癌、120例子宫颈上皮内瘤变(CIN)及20例正常子宫颈组织(对照组)中pax1蛋白表达水平,分析其子宫颈癌临床病理参数,采用受试者工作曲线(ROC)评估其诊断效能并随访,探讨其与子宫颈鳞癌(SCC)及子宫颈腺癌(AC)预后的关系。结果:①对照组的pax1蛋白表达水平(90.0%)高于CIN(73.3%)及子宫颈癌(38.6%),SCC患者pax1蛋白阳性表达率(20.9%)明显低于AC(70.0%)及特殊类型子宫颈癌(100.0%),差异有统计学意义(P<0.05)。②ROC曲线显示,pax1蛋白曲线下面积(AUC)为0.829,诊断子宫颈癌的灵敏度90.0%,特异度61.3%。③pax1蛋白阳性表达率与子宫颈癌患者的HPV感染、分化程度、组织类型及脉管浸润有关(P<0.05)。④SCC患者中pax1蛋白阳性组的生存时间明显高于阴性组(P=0.040),AC患者中pax1蛋白阳性组的生存时间与阴性组比较,差异无统计学意义(P=0.589)。结论:pax1蛋白的表达缺失与CIN及子宫颈癌进展密切相关,其诊断CINⅡ及以上的效能较高。pax1蛋白的表达缺失与SCC的发生发展及预后有一定的关系,pax1蛋白有望成为监测SCC患者预后的有效指标。

Objective:To investigate the protein expression of paired box gene 1(pax1)in cervical tissues and its clinical significance,and explore the relationship between pax1 protein and the prognosis of cervical squamous cell carcinoma(SCC).Methods:Immunohistochemical method was used to detect the expression of pax1 protein in 101 cases of cervical cancer,120 cases of cervical precancerous lesions(CIN)and 20 cases of the control group from China-Japan Friendship Hospital between August 2011 and October 2017.The clinicopathological parameters of cervical cancer and ROC were analyzed to evaluate the diagnostic efficiency.101 cases of cervical cancer were followed up to explore the relationship between pax1 protein expression and the prognosis of SCC and cervical adenocarcinoma(AC).Results:①The positive expression rate of pax1 protein in the control group(90.0%)was significantly higher than that in cervical cancer(38.6%)and CIN groups(73.3%).The positive expression rate of pax1 protein in cervical squamous cell carcinoma(20.9%)was significantly lower than that in cervical adenocarcinoma(70.0%)and special types of cervical cancer(100.0%).There was statistical difference(P<0.05).②ROC curve analysis showed that the area under pax1 protein curve was 0.829,the diagnostic sensitivity was 90.0%,and the specificity was 61.3%.③The positive expression rate of pax1 protein was related to HPV infection,differentiation degree,tissue type and vascular invasion in cervical cancer(P<0.05).④The survival time of positive expression of pax1 protein in SCC was longer than that of pax1 negative expression(P=0.040).Conclusions:The negative expression of pax1 protein is correlated with the occurrence and development of CIN and cervical cancer,and its diagnostic efficiency of CINII and above CINII is high.The negative expression of pax1 protein in SCC is significantly related to the prognosis.The protein of pax1 is expected to be an effective prognostic indicator for patients with cervical squamous cell carcinoma.