核不均一核糖核蛋白E 1和E 2与宫颈癌变及预后的关系

The relationship between nuclear heterogeneous ribonucleoprotein E 1 and E 2 and cervical canceration and prognosis

目的探讨核不均一核糖核蛋白(heterogeneous nuclear ribonul leoprotins,hnRNPs)E 1和E 2与宫颈癌变及其预后的关系。方法收集2013年6月至2018年6月辽阳市中心医院收治的112例宫颈癌患者肿瘤组织标本为宫颈癌组,同期100例宫颈上皮内瘤变(cervical intraepithelial,CIN)患者为CIN组,100例子宫良性疾病的正常宫颈组织标本为正常对照组。采用免疫组化法检测不同宫颈病变组中hnRNP E 1和E 2蛋白的表达情况。使用Kaplan-Meier和Log-Rank检验分别绘制生存曲线以及比较生存率来分析预后情况。结果hnRNP E 1、hnRNP E 2蛋白在宫颈癌组的阳性表达显著低于CIN组和正常对照组(P<0.05);hnRNP E 1、hnRNP E 2蛋白在3组中的表达两两比较发现,宫颈癌组与CIN组、正常对照组比较,差异均有统计学意义(P<0.05);CIN组和正常对照组比较,差异无统计学意义(P>0.05)。不同CIN分级中宫颈组织中hnRNP E 1、hnRNP E 2蛋白阳性率表达比较,差异有统计学意义(P<0.05);CIN I级组织中hnRNP E 1、hnRNP E 2蛋白阳性率表达高于CIN III级(P<0.05)。将hnRNP E 1、hnRNP E 2蛋白表达与宫颈癌患者临床病理特征相关分析得出,hnRNP E 1的蛋白阳性表达率与FIGO分期、宫颈癌分化程度、术后辅助治疗及淋巴结转移有关(P<0.05),与患者的年龄、病理组织类型、肿瘤直径、肌层浸润深度均不相关(P>0.05);hnRNP E 2的蛋白阳性表达率与FIGO分期、术后辅助治疗及淋巴结转移有关(P<0.05),与患者的年龄、病理组织类型、肿瘤直径、宫颈癌分化程度、肌层浸润深度均不相关(P>0.05)。分析112例宫颈癌患者随访情况,其中9例失访,15例死亡,hnRNP E 1蛋白表达阳性患者死亡率为4.5%(5/112),表达为阴性患者死亡率为14.3%(16/112),两者生存率比较差异有统计学意义(χ~2=4.535,P=0.033)。hnRNP E 2蛋白表达阳性患者死亡率为3.6%(4/112),表达为阴性患者死亡率为15.2%(17/112),两者生存率比较差异有统计学意义(χ~2=6.368,P=0.012)。结论hnRNP E 1和hnRNP E 2在宫颈癌患者中表达显著下调,两者表达与宫颈癌的发展转移密切相关,对指导宫颈癌患者的治疗、判断其预后有一定作用。

Objective To explore the relationship between nuclear heterogeneous ribonucleoprotein E 1 and E 2 and cervical cancer and its prognosis.Methods In this study,112 cervical cancer patients from June 2013 to June 2018 treated in Liaoyang City Central Hospital were set as cervical cancer group,and 100 patients with cervical intraepithelial neoplasia(CIN)during the same period were CIN group and 100 cases of benign uterine disease were normal control group.Immunohistochemical method was used to detect the expression of hnRNP E 1 and E 2 protein in different cervical lesion groups.Kaplan-Meier and Log-Rank tests were used to draw survival curves and compare survival rates to analyze prognosis.Results The results of immunohistochemistry showed that the positive expression of hnRNP E 1 and hnRNP E 2 protein in cervical cancer group was significantly lower than that in CIN group and normal control group(P<0.05);the difference of the expression of hnRNP E 1 and hnRNP E 2 protein between the CIN group and the normal control group was not statistically significant(P>0.05).The positive rate of hnRNP E 1,hnRNP E 2 protein in cervical tissues in different CIN grades was compared,the difference was statistically significant(P<0.05);the positive rate of hnRNP E1,hnRNP E 2 protein in CIN I tissues was higher than that of CIN III(P<0.05).Correlation analysis of hnRNP E 1,hnRNP E 2 protein expression and clinicopathological characteristics of cervical cancer patients showed that the positive expression rate of hnRNP E 1 protein was related to FIGO stage,cervical cancer differentiation degree,postoperative adjuvant therapy and lymph node metastasis(P<0.05),it was not related to the patient's age,clinicopathological tissue type,tumor diameter,and depth of muscular invasion(P>0.05);the positive expression rate of hnRNP E 2 protein was related to FIGO stage,postoperative adjuvant therapy,and lymph node metastasis(P<0.05).It was not related to the patient's age,clinicopathological type of tissue,tumor diameter,cervical cancer differentiation,and depth of muscle invasion(P>0.05).The follow-up of 112 cervical cancer patients was analyzed,of which 9 were lost to follow-up and 15 died.The mortality of patients with positive expression of hnRNP E 1 protein was 4.5%(5/112),and the mortality of patients with negative expression was 14.3%(16/112),the difference in survival rate between the two was statistically significant(χ^2=4.535,P=0.033).The mortality rate of patients with positive expression of hnRNP E 2 protein was 3.6%(4/112),and the mortality rate of patients with negative expression was 15.2%(17/112).The difference in survival rate between the two was statistically significant(χ^2=6.368,P=0.012).Conclusion The expressions of hnRNP E 1 and hnRNP E 2 are significantly down-regulated in cervical cancer patients,and their expressions are closely related to the development and metastasis of cervical cancer,and have a certain role in guiding the treatment of cervical cancer patients and judging their prognosis.