Expression of HMGB1 Protein in Human Cervical Squamous Epithelium Carcinoma

OBJECTIVE To investigate the expression of the high mobility group boxl（HMGB1） in human cervical squamous epithelial carcinoma （CSEC） and to explore the relationship of HMGB1 expression to the differentiation degree, size, invasion and metastasis of CSEC. METHODS Immunohistochemical staining of tissue microarrays and Western blot analysis were conducted to detect the expression of HMGB1 in the following tissue samples： 30 carcinoma in situ, 90 invasive CSEC without metastasis, 30 invasive CSEC with metastasis, 30 cases of normal cervical squamous epithelia. RESULTS The positive-expression rate of HMGB1 was 58.7% （88/150） in CSEC, showing a significant difference compared to normal cervical squamous epithelia. The expression of HMGB1 was correlated with tumor size, invasion and metastasis of CSEC （respectively, P〈0.01）, but had no relationship with the degree of differentiation （P〉0.05）. CONCLUSION The over-expression of HMGB1 in CSEC might be a useful parameter as an indication of tumor invasion, metastasis, prognosis and overall biological behavior of human CSEC, as well as a noval target site for gene therapy.

RELATIONSHIP BETWEEN CYCLIN G1 AND HUMAN PAPILLOMA VIRUS INFECTION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND CERVICAL CARCINOMA

Objective To evaluate the overexpression of cyclin G1 in cervical intraepithelial neoplasia （CIN） and cervical carcinoma, and the correlation between cyclin G1 and high-risk human papilloma virus （HPV） infection. Methods All of the specimens were obtained from the Department of Pathology of China-Japan Friendship Hospital from January 2000 to August 2004. We detected the expression of cyclin G1 with immunohistochemistry, HPV16/18 infection with in situ hybridization, and high-risk HPV infection with Hybrid capture system Ⅱ （HC-Ⅱ） in normal group （25 cases）, CIN Ⅰ （48 cases）, CIN Ⅱ （56 cases）, CIN Ⅲ（54 cases）, and invasive cervical squamous-cell carcinoma （SCC, 31 cases）. Results The positive rates of cyclin G1 expression in CIN（77.85% ）and SCC cervical tissues （87. 10% ） were significantly higher than normal （ 8.00%, P 〈 0. 01 ）, and the intensities of cyclin G1 expression in CIN（40. 60% ） and SCC cervical tissues （61.51%） were significantly higher than normal （2. 72%, P 〈0.05）. The positive rates and intensities of cyclin G1 expression increased gradually with the grade of cervical lesions. High-risk HPV infection rates were higher in CIN and SCC than normal groups （P 〈 0.05 ）. There was a positive correlation between cyclin G1 expression and high-risk HPV infection detected with HC-Ⅱ （Kendall＇s tau-b =0. 316, 0. 269, 0. 352, and 0. 474 in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ, and SCC, respectively, P 〈 0. 05 ）. Conclusions Cyclin G1 is overexpressed in CIN and SCC. Cyclin G1 may be a biomarker for detecting CIN and SCC. Cyclin G1 may play an important role in the oncogenesis of CIN and SCC by high-risk HPV infection.

Expression of Bmi-1,P16,and CD44v6 in Uterine Cervical Carcinoma and Its Clinical Significance

Objective Bmi-1, a putative proto-oncogene, is a core member of the polycomb gene family, which is expressed in many human tumors. The p16 protein negatively regulated cell proliferation, whereas CD44v6 is associated with proliferation as an important protein. Additionally, CD44v6 is an important nuclear antigen closely correlated to tumor metastasis. Tlle present study aims to investigate the expression and significance of Bmi-1, p16, and CD44v6 in uterine cervical carcinoma （UCC）. Methods A total of 62 UCC, 30 cervical neoplasic, and 20 normal cervical mucosal tissues were used ill the current study. The expression of Bmi-1, p16, and CD44v6 in these tissues was determined using immunohistochemical assay. The relationships among the expression of these indices, the clinicopathologic features of UCC, and the survival rate of UCC patients were also discussed. The correlation between Bmi-1 protein expression and p16 or CD44v6 protein in UCC was analyzed. Results The expression of Bmi-l, p16, and CD44v6 was significantly high in cervical carcinoma compared with that in tlle cervical neoplasia and normal colorectal mucosa （P〈0.05）. The over-expression of Bmi-1 protein in UCC was apparently related to the distant metastasis （P〈0.01） and the tumor, nodes and metastasis-classification, i.e. the TNM staging, World Health Organization （P〈0.05）. Nevertheless, the positive expression of p16 protein in UCC was not significantly associated with the clinicopathologic features （P〉0.05）. The Kaplan-Meier survival analysis showed that the over-expression of Bmi-1 significantly decreased the survival rate of UCC patients （P〈0.05）. A strong correlation indicated that there was statistical significance between the expression of Bmi-1 and CD44V6 proteins in UCC （r=0.419, P=0.001）. Conclusions The over-expression of Bmi-1 and CD44v6 protein closely correlate to the tumorigenesis, metastasis, and prognosis of UCC. Bmi-I and CD44v6 may be used to predict the prognosis of cervical carcinoma. Bmi-1 may indirectly regulate the expression of CD44v6 in UCC patients. The positive expression of p16 protein is possibly associated with the tumorigenesis, but not with the metastasis or prognosis of UCC.

Relationship between Microsatellite Alterations of RASSF1A Gene and Development of Cervical Carcinoma

Objective： To explore the relationship between microsatellite alterations of RASSFIA gene and the development of cervical carcinoma, and its relationship with HPV16 infection. Methods： Two sites of microsatellite polymorphism of RASSFIA gene were selected. Polymerase chain reaction （PCR） technique was used to detect LOH and MSI in 50 cases of cervical carcinoma and 40 cases of cervical intraepithelial neoplasia （CIN）, and to detect the infection state of HPV16. Results： At D3S1478 and D3S4604, the LOH rates of cervical carcinomas were 32.6% （14/43） and 48.9% （23/47）, the MSI rates were 14% （6/43） and 19.1% （9/47）, respectively. The LOH rates of CINs were 31.4% （11/35） and 39.5% （15/38）, the MSI rates were 11.4% （4/35） and 15.8% （6/38）, respectively. There were no significant differences between cervical carcinomas and CINs in respect to their positive rates of LOH and MSI at D3S1478 and D3S4604 （P〉0.05）. There were significant differences in LOH rates at D3S1478 and D3S4604 between the stage Ⅰ-Ⅱ and Ⅲ-Ⅳ cervical carcinomas and between the well/moderately differentiated cervical carcinomas and the poorly differentiated cervical carcinomas （P〈0.05）. The positive rates of LOH and MSI for CIN Ⅲ and noninvasive cervical carcinomas were higher than those in CIN Ⅰ-Ⅱ. The rates of infection of HPV16 in cervical cancer was obviously higher than that in CIN and in normal cervical tissues （P〈0.05）, and the incidence of LOH of RASSFIA gene was higher in HPV16（＋） than that in HPV16（-） （P〈0.05）. Conclusion： The RASSFIA gene change is a relatively late event in cervical carcinomas. The detection of LOH and MSI of RASSFIA gene might be helpful to the early diagnosis and the screening of cervical carcinoma. It might also be useful for predicting the prognosis of cervical carcinoma.

Expression and role of AQP1 in cervical squamous carcinoma and its precancerous lesions

Objective： To investigate the expression of aquaporin 1 in cervical squamous carcinomas （CSC） and cervical precancerous lesions, and the relationship between the tumor clinicopathological parameters, prognosis and the expression of AQP1. Methods： Immunohistochemical method （EliVision） was used to detect the expression of AQP1 in samples from 106 patients [20 with normal cervical tissue, 30 with cervical intraepithelial neoplasia （stage Ⅰ and Ⅱ） and 56 with CSC]. Survival analysis was performed by Kaplan-Meier method. Results： AQP1 protein was expressed in vascular endothelia of all samples. It showed upregulation of AQP1 expression in CSC. There was a significant difference between CSC and normal cervical tissues （P〈0.05）. AQP1 was expressed in some tumor cells and unexpressed in normal squamous epithelial cells. And APQl-expressing tumor cells were positively related to lymph node metastasis. Patients with APQl-expressing tumor cells had the lower survival rate than the ones without. Conclusion： Abnormal expression of AQP1 plays an important role in the development of CSC. Positive expression of AQP1 in tumor cells maybe enhances tumor metastasis and could be used as a marker for tumor prognosis.

Expression and Clinical Significance of HMGB1 and RAGE in Cervical Carcinoma

OBJECTIVE To study the expression level and clinical significance of HMGB1 and RAGE in cervical squamous epithelial carcinoma. METHODS Real time quantitative polymerase chain reaction （qRT-PCR） was employed to examine the expression of HMGB1 （high mobility group box protein1）, and RAGE （receptor for advanced glycation endproducts） in 60 cervical squamous epithelial carcinomas （CSEC）, their paraneoplastic tissues （PS） and 30 normal cervix tissues （NCS）. RESULTS The expression of HMGB1 in the CSEC samples and PS was similar （P〉0.05）, but higher compared to NCS （P〈0.05）. Overexpression of HMGB1 in the CESC tissues was significantly correlated with the tumor （P〈0.05）, and the presence of metastasis （P〈0.01）, but not correlated with the tumor diameter or tumor grade.RAGE expression was not significantly different among these tissue types, and showed no significant correlation with the the tumor stage, diameter or grade. But there was a significant positive correlation between RAGE expression and CSEC metastasis. CONCLUSION The results suggest that HMGB1 may be related to the proliferation, progression and metastasis of CSEC. The relationship of HMGBI/RAGE may be of importance for CSEC metastasis. HMGB1 presents a new potential gene target for prevention and treatment of CSEC. Study of HMGBI/RAGE expression will offer an experimental foundation for understanding the pathogenesis of CSES.

THE OVEREXPRESSION AND SIGNIFICANCE OF CYCLIN D1 AND P53 IN CERVICAL SQUAMOUS CELL CARCINOMAS

Objective To investigate the significance of overexpresson of cyclin D1 and P53 protein in cervical squamous cell carcinomas.Methods Fifty cases of invasive cervical squamous cell carcinomas and 10 cases of normal cervical squamous epithelia were investigated with immunihistochemical technique. Results The overexpression of cyclin D1 and P53 in invasive cervical carcinomas was 70% and 50%, respectively. There was no overexpression of them in the control group. The overexpression of cyclin D1 in grade Ⅱ and Ⅲ was much higher than that in gradeⅠ(P<0.05). The overexpresson of cyclin D1 in stage Ⅲ of cervical carcinoma was significantly higher than that in stage Ⅱ (P<0.05). The overexpression of P53 in grade Ⅱ and grade Ⅲ of cervical carcinoma was remarkably higher than that in grade Ⅰ (P<0.05).Conclusion The action point of both cyclin D1 and P53 may be at G1/S transition. The overexpression of them was associated with development and progression of cervical carcinoma probably in different mechanisms and different pathways.

Expression and clinical significance of Klotho and Beclin1 in cervical squamous carcinoma

Objective:To detect the expression of klotho and beclin1 protein in chronic cervicitis, low grade squamous intraepithelial lesion (LSIL) group, high grade squamous intraepithelial lesion (HSIL) group and cervical squamous cell carcinoma (SCC) group.Methods:Immunohistochemical technique (Envision) was used to detect the expression of Klotho and Beclin1 proteins in each study group. The correlation between the expression of the above two proteins and the pathological features of SCC and the expression of the two proteins in SCC were analyzed.Results: The positive expression rates of Klotho protein in chronic cervicitis group, LSIL group, HSIL group and SCC group were 95%, 92.86%, 65.38%, 27.90%, respectively. The positive rates of Beclin1 protein in chronic cervicitis group, LSIL group, HSIL group were 25.0%, 28.57%, 38.46% and 74.42%, respectively. The differences were statistically significant. The expression of Klotho and Beclin1 in SCC was correlated with the degree of tumor differentiation, but not with the age, figo stage, lymph node metastasis, tumor size, depth of invasion and vessel invasion, but not with the age of the patient, tumor figo stage, lymph node metastasis, tumor size, depth of invasion and vessel invasion. There was no correlation between the expression of klotho and beclin1 in SCC tissues.Conclusion: The abnormal expression of klotho and beclin1 may be related to the development, invasion and metastasis of cervical squamous cell carcinoma.

冠心病合并高血压患者血清LncRNA CCHE1、TCF21与心肌缺血的相关性

目的探讨冠心病(CHD)合并高血压患者血清长链非编码核糖核酸宫颈癌高表达1(LncRNA CCHE1)、转录因子21(TCF21)与心肌缺血的相关性。方法选取2020年12月—2023年12月陕西省榆林市第一医院心血管内科收治的合并高血压的CHD患者110例为高血压组,未合并高血压的CHD患者110例为非高血压组,根据是否发生心肌缺血将高血压组分为心肌缺血亚组79例和无心肌缺血亚组31例。采用实时荧光定量PCR法测定血清LncRNA CCHE1、TCF21表达;Pearson相关性分析血清LncRNA CCHE1、TCF21表达与心肌缺血总负荷(TIB)的相关性;多因素Logistic回归分析CHD合并高血压患者发生心肌缺血的影响因素;受试者工作特征(ROC)曲线评价血清LncRNA CCHE1、TCF21表达对CHD合并高血压患者发生心肌缺血的诊断价值。结果高血压组血清LncRNA CCHE1表达高于非高血压组,血清TCF21表达低于非高血压组(t/P=19.133/<0.001、17.259/<0.001);心肌缺血亚组BMI、收缩压、三支血管病变比例、血清Hcy水平、TIB、血清LncRNA CCHE1表达高于无心肌缺血亚组,血清TCF21表达低于无心肌缺血亚组(t/P=3.524/0.001、2.705/0.008、12.265/0.002、5.280/<0.001、24.638/<0.001、15.994/<0.001、9.280/<0.001);Pearson相关性分析显示,CHD合并高血压患者血清LncRNA CCHE1表达与TIB呈正相关(r=0.536,P<0.001),血清TCF21表达与TIB呈负相关(r=-0.508,P<0.001);多因素Logistic回归分析显示,三支血管病变、LncRNA CCHE1表达高是CHD合并高血压患者发生心肌缺血的独立危险因素[OR(95%CI)=3.465(1.534~7.833)、1.743(1.135~2.678)],TCF21表达高是独立保护因素[OR(95%CI)=0.528(0.312~0.895)];血清LncRNA CCHE1、TCF21表达及二者联合诊断CHD合并高血压患者发生心肌缺血的曲线下面积(AUC)分别为0.778、0.760、0.896,二者联合的AUC大于血清LncRNA CCHE1、TCF21表达单独诊断的AUC(Z/P=2.636/0.002、3.088/<0.001)。结论CHD合并高血压患者血清LncRNA CCHE1表达增高、TCF21表达降低与心肌缺血有关,二者联合在心肌缺风险诊断中具有较高价值。

PD⁃1抑制剂联合全身化疗治疗复发转移性宫颈癌的临床效果观察

目的探讨程序性细胞死亡受体-1(PD-1)抑制剂(卡瑞利珠单抗)免疫治疗联合全身化疗治疗复发转移性宫颈癌的临床效果。方法选择2019年2月—2021年6月定州市人民医院收治的复发转移性宫颈癌64例,依据随机数字表法分为研究组和对照组各32例。对照组给予紫杉醇联合顺铂全身化疗方案,研究组给予全身化疗方案+PD-1卡瑞利珠单抗免疫治疗。比较2组临床疗效,分析治疗前及治疗3个周期后鳞状细胞癌抗原(SCC)、外周血淋巴细胞/单核细胞(LMR)及血小板/淋巴细胞(PLR)指标水平及Kamofsky评分变化,并观察治疗期间毒性作用发生情况及随访期间患者总生存期。结果研究组总有效率、疾病控制率分别为93.75%(30/32)、96.88%(31/32),高于对照组的68.75%(22/32)、75.00%(24/32),差异有统计学意义(P<0.05)。治疗3个周期后,2组血清SCC、PLR水平较治疗前降低,LMR较治疗前升高,且研究组改善程度优于对照组(P<0.05)。治疗后,2组Kamofsky评分均较治疗前升高,且研究组高于对照组(P<0.05)。治疗后研究组1、2年生存率及总生存期高于或长于对照组(P<0.05)。2组毒性作用多数为1~2级。研究组血小板下降和转氨酶升高比例分别为37.50%(12/32)和28.12%(9/32),高于对照组的18.75%(6/32)和9.38%(3/32),差异有统计学意义(P<0.05);2组贫血、白细胞下降、恶心、腹泻、乏力等毒性作用发生率比较差异无统计学意义(P>0.05);研究组中发生反应性毛细血管增生症、甲状腺功能减退、皮疹、带状疱疹、过敏等经对症处理后症状消失。结论PD-1抑制剂联合全身化疗治疗复发转移性宫颈癌提高了临床效果、生存质量及生存率,延长生存期,改善了机体的炎症免疫反应状态,毒性作用较少,患者耐受性好。

宫颈癌患者血清微小RNA-195、双皮质素样激酶1、鳞状细胞癌抗原表达水平与临床病理特征及预后相关性研究

目的:探讨宫颈癌患者血清微小RNA-195(miR-195)、双皮质素样激酶1(DCLK1)、鳞状细胞癌抗原(SCC-Ag)水平与临床病理特征及预后的相关性。方法:选取宫颈癌患者72例为观察组,同期体检健康女性60例为对照组,比较两组血清miR-195、DCLK1、SCC-Ag表达水平。采用Spearman法分析宫颈癌患者血清miR-195、DCLK1、SCC-Ag与临床病理特征的相关性,随访3年,记录患者生存情况。采用Cox回归模型分析宫颈癌患者预后的影响因素。结果:观察组血清DCLK1、SCC-Ag水平较对照组升高,miR-195水平较对照组下降(均P<0.05)。血清miR-195水平与淋巴结转移、国际妇产科联盟(FIGO)分期、肿瘤分化程度呈负相关,DCLK1水平与FIGO分期、肿瘤分化程度呈正相关,SCC-Ag水平与肿瘤分化程度、肿瘤直径呈正相关(均P<0.05)。miR-195高表达患者3年生存率高于低表达患者,DCLK1、SCC-Ag高表达患者3年生存率低于低表达患者(均P<0.05)。FIGO分期、分化程度、淋巴结转移、肿瘤直径及血清miR-195、DCLK1、SCC-Ag水平是宫颈癌患者预后的独立影响因素(均P<0.05)。结论:宫颈癌患者血清DCLK1、SCC-Ag水平升高,miR-195水平降低,三者与临床病理特征和预后有关,是宫颈癌患者预后的独立影响因素。

宫颈癌组织中机械敏感离子通道蛋白1表达变化及M1/M2型巨噬细胞浸润情况观察分析

目的观察宫颈癌组织中机械敏感离子通道蛋白1(Piezo-type mechanosensitive ion channel component 1,Piezo1)的表达变化及M1/M2型巨噬细胞浸润情况,探讨其可能作用机制。方法选择病理明确诊断为宫颈癌患者的宫颈癌组织35例份、子宫肌瘤或子宫腺肌瘤行子宫全切患者正常宫颈组织30例份,分别采用免疫组织化学染色法及Western Blotting法检测Piezo1。从TCGA宫颈癌RNA-seq数据库中,使用R软件通过CIBERSORT法分析不同Piezo1表达的宫颈癌组织22种免疫细胞浸润情况,利用GSEA 4.2.3软件筛选1NES1>1、P<0.05、FDR<0.25的Piezo1巨噬细胞相关信号通路。采用免疫组织化学染色法和Pearson相关性分析法分析Piezo1表达与宫颈癌组织M1/M2巨噬细胞浸润的相关性。结果与正常宫颈组织相比,宫颈癌组织Piezo1相对表达量高(P<0.05)。宫颈癌组织和正常宫颈组织中M1巨噬细胞浸润强度为7.70±1.31、7.17±2.05(P>0.05),M2巨噬细胞浸润强度分别为16.21±6.36、3.89±1.56(P<0.05)。Piezo1表达与宫颈癌组织M2型巨噬细胞浸润水平成正相关(r=0.8617,P<0.001)。与Piezo1低表达者相比,Piezo1高表达的宫颈癌组织M2型巨噬细胞比例高(P<0.01)。Piezo1与M2型巨噬细胞极化细胞相关信号通路主要有IL6/JAK/STAT3信号通路、TGF-β信号通路及TNF-α/NF-κB信号通路。结论Piezo1在宫颈癌组织中高表达、M2巨噬细胞浸润多。Piezo1可能通过激活宫颈癌组织IL6/JAK/STAT3信号通路、TGF-β信号通路和TNF-α/NF-κB信号通路,促进M2型巨噬细胞极化,参与宫颈癌的发生发展。

PD-1抑制剂帕博利珠单抗用于宫颈癌治疗效果的影响因素研究

目的探讨程序性死亡受体1(PD-1)抑制剂帕博利珠单抗用于宫颈癌治疗效果的影响因素。方法回顾性分析2020年1月至2023年10月安徽省妇女儿童医学中心妇产科收治的使用帕博利珠单抗宫颈癌患者临床资料,根据疗效分为无效组和有效组。比较两组患者的临床资料[年龄、肿瘤类型、病理类型、病灶大小、分化程度、妊娠次数、生产次数、流产次数、绝经情况、肿瘤突变负荷(TMB)、DNA修复基因突变情况、PD-L1表达情况、糖尿病、高血压、治疗模式、体质量指数、肿瘤侵润淋巴细胞(TIL)表达情况、新抗原瘤内异质性(ITH)情况、有无肝病、家族史],采用Logistic回归分析确定影响宫颈癌患者帕博利珠单抗疗效的危险因素。结果研究共纳入60例患者,有效组42例,无效组18例。无效组TMB<143/Mb、DNA修复基因未突变、PD-L1低表达、单纯免疫治疗、TIL阴性、ITH高的患者占比均高于有效组(P<0.05)。多因素Logistic回归分析显示,TMB<143/Mb、DNA修复基因未突变、PD-L1低表达、单纯免疫治疗、TIL阴性、ITH高均是影响宫颈癌患者帕博利珠单抗疗效的危险因素(P<0.05)。结论宫颈癌患者PD-1抑制剂帕博利珠单抗疗效受TMB、DNA修复基因突变、PD-L1表达、治疗模式、TIL、ITH等因素的影响。

乳腺癌组织中lncRNA CCHE1水平及其临床意义

目的探讨长链非编码RNA(lncRNA)CCHE1在乳腺癌组织中的表达及其临床意义。方法收集本院2011年1月至2012年12月切除的乳腺癌组织115例和配对癌旁组织78例,采用实时荧光定量PCR(QPCR)检测CCHE1在上述组织中的表达情况,比较乳腺癌组织和癌旁组织中的CCHE1水平;分析CCHE1水平与乳腺癌临床病理参数(年龄、临床T分期、组织学分级、淋巴结转移、Nottingham预后指数、Ki-67增殖指数、ER表达、PR表达及HER-2扩增)和复发的关系;分析不同CCHE1水平的总生存期(OS)和无进展生存期(PFS),采用Cox比例风险模型进行多因素分析。结果 QPCR检测发现,115例乳腺癌组织中的CCHE1水平为7.610±3.210,高于癌旁组织的2.142±1.753(P<0.05)。CCHE1水平与临床T分期、淋巴结转移、Nottingham预后指数、HER-2扩增和肿瘤复发有关(P<0.05),而与年龄、组织学分级、ER表达、PR表达和Ki-67增殖指数无关(P>0.05)。CCHE1低表达组的中位PFS和OS分别为56.0个月和63.0个月,均优于高表达组的37.0个月和42.0个月(P<0.05);CCHE1水平、临床T分期、淋巴结转移、Nottingham预后指数和HER-2扩增是影响OS和PFS的独立预后因素(P<0.05)。结论 CCHE1在乳腺癌组织中表达升高,该lncRNA可能在乳腺癌的发生、发展中有一定作用,可作为潜在地评估乳腺癌患者预后的分子标志物。

Ets-1和survivin在宫颈鳞状细胞癌中的表达研究

目的 探讨宫颈鳞状细胞癌(宫颈鳞癌)Ets-1和survivin表达与患者临床病理指标的关系。方法应用免疫组化EliVision^(TM) plus二步法检测72例宫颈鳞癌手术标本及30例癌旁宫颈组织Ets-1和survivin表达,分析其表达与患者年龄、癌灶大小、浸润深度、分化等级、TNM分期、术前淋巴转移、术后5年内复发转移7项指标的关系。结果 Ets-1阳性染色可见于细胞核及细胞质,survivin阳性染色多见于细胞质,少见于细胞核。癌组织Ets-1和survivin阳性率(分别为63.9%,72.2%)均显著高于癌旁组织(分别为13.3%,3.3%)(P<0.05)。患者年龄、癌灶大小均与Ets-1和Survivin表达阳性率无关(P>0.05);浸润深度、分化等级、TNM分期、术前淋巴转移、术后5年内复发转移5项指标均与Ets-1和survivin表达阳性率相关(P<0.05)。72例患者Ets-1和survivin共阳率为58.3%,共阴率为22.2%,两者表达呈正相关(r=0.49,P<0.05)。结论 Ets-1和survivin与宫颈鳞癌的发生发展密切相关,两者高水平表达预示癌组织侵袭能力强、分化等级低、病情发展快、淋巴转移早、患者预后差。

血清细胞程序性死亡蛋白5、信号转导与转录激活因子1水平与宫颈鳞状细胞癌患者临床特征及预后的关系

目的探讨血清细胞程序性死亡蛋白5(PDCD5)、信号转导与转录激活因子1(STAT1)水平与宫颈鳞状细胞癌(CSCC)患者临床特征及预后的关系。方法选取68例CSCC患者和60例健康体检者,分别纳入CSCC组和健康组。比较两组受试者及不同临床特征CSCC患者血清PDCD5、STAT1水平。CSCC患者预后的影响因素采用多因素Cox回归模型分析。结果CSCC组患者血清PDCD5、STAT1水平均明显低于健康组,差异均有统计学意义(P﹤0.01)。有淋巴结转移、分化程度为低分化、临床分期为Ⅲ+Ⅳ期CSCC患者血清PDCD5、STAT1水平分别低于无淋巴结转移、分化程度为中高分化、临床分期为Ⅰ+Ⅱ期患者,差异均有统计学意义(P﹤0.05)。随访12个月,68例CSCC患者中,生存62例,死亡6例。多因素Cox分析结果显示,血清PDCD5﹤0.75 ng/ml、STAT1﹤54.69μg/L、淋巴结转移均是CSCC患者预后不良的独立危险因素(P﹤0.05)。结论CSCC患者血清PDCD5、STAT1水平较低,血清PDCD5﹤0.75 ng/ml、STAT1﹤54.69μg/L、淋巴结转移均是CSCC患者预后不良的独立危险因素。

小凹蛋白-1、小凹蛋白-2在宫颈鳞状细胞癌及鳞状上皮内病变中的表达及意义

目的探讨小凹蛋白(Cav)-1、Cav-2在宫颈鳞状细胞癌及鳞状上皮内病变组织中的表达及意义。方法收集2016年1月至2020年12月乌鲁木齐市妇幼保健院病理科的宫颈手术切除石蜡包埋组织样本,包括正常组织40例、宫颈低级别鳞状上皮内病变(LSIL)组织样本40例、宫颈高级别鳞状上皮内病变(HSIL)组织样本40例、宫颈鳞状细胞癌组织样本40例。应用免疫组织化学法检测正常组织、宫颈HSIL组织样本、宫颈LSIL组织样本及宫颈鳞状细胞癌组织样本中Cav-1、Cav-2的表达,应用实时荧光定量聚合酶链反应技术检测宫颈鳞状细胞癌和正常组织中Cav-1、Cav-2及上皮-间充质转化相关分子[表皮生长因子受体(EGFR)、上皮钙黏素(E-cadherin)、神经钙黏素(N-cadherin)及波形蛋白(Vimentin)]的信使RNA表达。结果宫颈鳞状细胞癌组Cav-1评分高于正常组、宫颈LSIL组、宫颈HSIL组[6.00(6.00,8.25)分比0.00(0.00,1.00)分、0.00(0.00,1.00)分、0.00(0.00,0.00)分](P<0.05),宫颈HSIL组与宫颈鳞状细胞癌组Cav-2评分均高于正常组和宫颈LSIL组,且宫颈鳞状细胞癌组Cav-2评分高于宫颈HSIL组[9.00(6.00,9.00)分比2.00(2.00,3.00)分](P<0.05)。宫颈鳞状细胞癌组Cav-1表达低于正常组(P<0.05);正常组与宫颈鳞状细胞癌组Cav-2、EGFR、E-cadherin、N-cadherin及Vimentin表达比较差异无统计学意义(P>0.05)。结论Cav-1、Cav-2在宫颈鳞状细胞癌中的表达明显高于宫颈鳞状上皮内病变及正常组织,证实其参与了宫颈鳞状细胞癌的发生发展;Cav-2在宫颈HSIL中的表达明显高于宫颈LSIL和正常组织,故Cav-2可能作为宫颈鳞状上皮内病变分级的鉴别诊断标志物。

17例子宫颈原发性淋巴上皮瘤样癌的临床病理特征

目的:子宫颈原发性淋巴上皮瘤样癌(lymphoepithelioma-like carcinoma,LELC)在组织学上与鼻咽部LELC相似,是宫颈鳞状细胞癌的一种罕见变异型,占宫颈原发性恶性肿瘤的0.7%。本研究探讨子宫颈原发性LELC的临床病理特征、鉴别诊断及细胞程序性死亡受体配体1(programmed death-ligand 1,PD-L1)的表达情况。方法:收集2009年4月至2023年12月17例宫颈原发性LELC患者发病年龄为34~71岁。均行外科广泛全子宫、双侧附件、盆腔淋巴结清扫手术,其中9例患者国际妇产科联合会(International Federation of Gynecology and Obstetrics,FIGO)分期为Ⅰb1期,7例为Ⅰb2期,1例为Ⅱa1期。随访时间为8~157个月。回顾性分析17例患者的临床病理特征、免疫表型及预后。结果:光镜下肿瘤排列呈巢团状,间质可见大量淋巴细胞、浆细胞弥漫浸润;高倍镜下可见瘤细胞体积大,呈多边形或短梭形,细胞质丰富、嗜酸,边界不清呈合胞体样,细胞核圆形或卵圆形,呈空泡状,可见核仁,核分裂象易见。免疫表型检查示:17例宫颈原发性LELC患者细胞角蛋白7(cell keratin 7,CK7)、p16及p40呈不同程度的阳性表达;2例有脉管侵犯者平足蛋白(podoplanin,D2-40)、细胞分化簇34(cluster of differentiation 34,CD34)呈阳性表达;细胞增殖指数Ki-67为40%~95%;PD-L1免疫组织化学评分(tumor proportion score,TPS)为20%~100%,联合阳性评分(combined positive score,CPS)为30~100;EB病毒编码区(Epstein-Barr encoding region,EBER)原位杂交阳性率为17.6%。结论:子宫颈原发性LELC预后较好,发病时临床分期均在Ⅰ~Ⅱ期,外科手术后复发及转移罕见。镜下特征为瘤细胞体积大,呈合胞体样,间质可见大量淋巴细胞、浆细胞弥漫浸润。免疫组织化学结果显示子宫颈原发性LELC可高表达PD-L1,提示此类患者或许能从免疫检查点抑制剂的治疗中获益,从而延长生存期。

PROGNOSTIC FACTORS IN CERVICAL CARCINOMA

Objective: To evaluate factors for prognosis of cervical carcinoma. Methods: Expressions of mn23- HI, erbB3 and erbB4 were examined by immunohistochemical staining. The apoptosis was detected in situ by the TdT mediated duip-biotin nick end-labeling (TUNEL) technique. Mitotic cell were counted by HE dyeing. Results: FIGO stage and lymph node metastasis were the most important factors for evaluating prognosis in adenocarcinoma or squamous cell carcinoma. AI/MI was positively correlated with 5-year survival of cervical carcinoma. Positive expression of nm23-H1 combed with negative expression of erbB4 [nm23-H1(+)/erbB4(?)] predicted good prognosis for adenocarcinoma. In multivariable Cox regression analysis, only FIGO stage and AI/MI were into equation. Conclusion: FIGO stage and AI/MI were independent evaluating parameter for adenocarcinoma or squamous cell carcinoma.

GENETIC INSTABILITY IN CERVICAL CARCINOMA

Objective: The role of human papillomavirus (HPV) in the development of cervical carcinoma has been clearly established but other factors could be involved in cervical tumorigenesis such as loss of heterozygosity (LOH) and microsatellite instability (MI). The aim of the present study was to investigate the genetic instability in cervical carcinoma tissues and provide evidence for discovering new tumor suppressor genes and screening diagnostic molecular marker of cervical carcinoma. Methods: Fifty primary cervical carcinoma samples from high-incidence area were analyzed by PCR for HPV16 infection, LOH and microsatellite instability. Results: HPV16 was detected in 88% of the cases. Sixty-six percent of total cases showed LOH with no more than 3 different loci per case. The highest frequency of the allelic loss was found in D18S474 (18q21, 40.5%). MI was detected in 4 cases (8%) only. Conclusion: Different percentages of LOH on specific chromosomal regions were found and MI was very infrequent in cervical carcinoma. The putative suppressor gene(s) could be located on specific chromosome regions such as 18q, and genetic instability could be involved in cervical tumorigenesis.