女性外阴尖锐湿疣的克隆性

Clonality of condyloma acuminatum in vulva

目的 根据女性体细胞中两条X染色体上雄激素受体 (AR)基因的长度多态性进行非放标克隆性检测 ,以探讨尖锐湿疣的克隆组成。方法 石蜡切片HE染色后进行显微解剖 ,提取基因组DNA ,Hha Ⅰ消化 ,巢式PCR扩增 ,变性聚丙烯酰胺凝胶电泳后银染显示单股DNA片段长度。结果 在 68例湿疣标本中 ,65例扩增成功 ,其中 53例 (81 5 % )具有AR位点的多态性 ;在适于分析的 45例中 ,9例 (2 0 % )显示AR位点长度多态性丢失 ,属于单克隆性增生 ;其余 36例 (80 % )无多态性丢失 ,提示为多克隆增生。单克隆性病变的核分裂指数明显高于多克隆病变 ,但二者的凋亡小体计数差异不显著。结论 大部分尖锐湿疣属于多克隆性病变 ,属反应性增生 ;少部分是克隆性增生 。

Objective To demonstrate the clonality status of condyl oma a cuminatum in the vulva using an assay based on inactivation mosaicism of the len gth-polymorphic X chromosomes at the androgen receptor (AR) locus Methods Proliferative epithelial component of the condyloma l esions was microdissectied from the routine sections stained wit h hematoxylin and eosin Stroma component was also isolated from the same sampl es, and used for parallel controls. Genomic DNA was extracted, pretreated with Hha I, and amplified via nested PCR The products were resolved on denaturi ng po lyacrylamide gels and visualized through silver staining Results A total of 68 cases were examined, in which 65 samples wer e successfully amplified and 53 (81 5%) of them carrying the length polymorphis m at the AR locus Forty-five samples were suitable for the clonality test Among them, 36 (80%) were shown to be polyclonal Loss of X-chromosome inactiv ation mosaicism was found in 9 lesions, reflecting their monoclonal cell composi tion Mitotic indices of the monoclonal lesions were higher than those of the polyclonal lesions, but no difference was found between their apoptotic body cou nts Conclusions In the vulva, most of condylomata acuminata are polyclonal, thereby being responsive proliferative lesions Some of the co ndyloma lesions, however, show monoclonal cell expansion, suggesting that they m ay be already neoplastic