Twist、E-cadherin、N-cadherin在宫颈鳞癌中的表达及意义

目的 探讨上皮间质转化因子Twist及相关黏附分子E-cadherin、N-cadherin在人宫颈鳞癌、宫颈上皮内瘤变(CIN)和正常宫颈上皮组织中的表达及临床病理意义.方法 利用免疫组织化学方法检测61例宫颈鳞癌标本、22例CIN Ⅰ级标本、44例CINⅡ-Ⅲ级标本及22例正常宫颈标本中Twist、E-cadherin、N-cadherin蛋白的表达及其与宫颈鳞癌临床生物学行为的关系.结果 正常宫颈组织Twist蛋白阳性表达率(0)与CIN Ⅰ级组织(40.90％)、CINⅡ～Ⅲ级组织(68.18％)、宫颈鳞癌组织(70.49％)比较,差异均具有统计学意义(P＜0.05)；正常宫颈组织中E-cadherin蛋白的阳性表达率(90.91％)明显高于CINⅡ～Ⅲ级组织(54.55％)和宫颈鳞癌组织(14.75％)(均P ＜0.05)；宫颈鳞癌组织N-cadherin蛋白的阳性表达率(90.16％)明显高于正常富颈组织(27.27％)、CIN Ⅰ级组织(50.00％)、CINⅡ～Ⅲ级组织(68.18％)(均P＜0.05).在61例宫颈鳞癌组织中,Twist蛋白与E-cadherin蛋白表达呈负相关(r=-0.339,P＜0.01),而Twist蛋白与N-cadherin蛋白表达呈正相关(r=0.390,P＜0.01).在61例宫颈鳞癌组织中,不同国际妇产科联盟(FIGO)分期的组织间Twist、E-cadherin、N-cadherin蛋白阳性表达率比较,差异均无统计学意义(P＞0.05)；有无淋巴血管间隙浸润的组织间比较,差异也均无统计学意义(P＞0.05)；Twist蛋白在高分化或中分化宫颈鳞癌组织中的阳性表达率(60.47％)明显低于低分化或未分化组织(94.44％) (P ＜0.05)；Twist蛋白在无淋巴结转移的宫颈鳞癌组织中的阳性表达率(62.22％)明显低于有淋巴结转移的组织(93.75％)(P＜0.05).结论 Twist在宫颈鳞癌中高表达,且与肿瘤分化及淋巴结转移相关；Twist、E-cadherin和N-cadherin的异常表达可能参与了宫颈鳞癌的浸润及转移.

Expression and clinical significance of Twist, E-cadherin and N-cadherin in cervical squamous cell carcinoma

Objective To investigate the expression and clinical significance of epithelial-mesenchymal transition factor of Twist and related adhesion molecules E-cadherin and N-cadherin in human cervical squamous cell carcinoma,cervical intraepithelial neoplasia(CIN) and normal cervical tissues.Methods The expression of Twist,E-cadherin and N-cadherin protein in 61 samples of cervical cancer,22 samples of CINⅠ,44 samples of CINⅡ-Ⅲ and 22 samples of normal cervical tissues was detected by immunohistochemistry,and its relationship with clinical biological behaviors of cervical squamous cell carcinoma was explored.Results The positive expression rate of Twist protein in normal cervical tissues(0%) was significantly different from those of CINⅠ tissues(40.90%),CINⅡ-Ⅲ tissues(68.18%) and cervical squamous cell carcinoma tissues(70.49%)(P<0.05 for all).The positive expression rate of E-cadherin protein in normal cervical tissues(90.91%) was significantly higher than those in CINⅡ-Ⅲ tissues(54.55%) and cervical squamous cell carcinoma tissues(14.75%)(P<0.05 for both).The positive expression rate of N-cadherin protein in cervical squamous cell carcinoma tissues(90.16%) was significantly higher than those in normal cervical tissues(27.27%),CIN I tissues(50.00%) and CINⅡ-Ⅲ tissues(68.18%)(P<0.05 for all).In 61 samples of cervical squamous cell carcinoma tissues,the expression of Twist protein was negatively related to that of E-cadherin protein(r=-0.339,P<0.01),while the expression of Twist protein was positively related to that of N-cadherin protein(r=0.390,P<0.01).In 61 samples of cervical squamous cell carcinoma tissues,there was no significant difference in the positive expression rates of Twist,E-cadherin and N-cadherin protein among different stages by International Federation of Gynecology and Obstetrics(FIGO)(P>0.05 for all),and there was also no significant difference in the positive expression rates of Twist,E-cadherin and N-cadherin protein between tissues with lymphovascular space invasion and those without lymphovascular space invasion(P>0.05 for all).The positive expression rate of Twist protein in well-differentiated and moderately-differentiated cervical squamous cell carcinoma tissues(60.47%) was significantly lower than that in poorly-differentiated and undifferentiated tissues(94.44%)(P<0.05),and the positive expression rate of Twist protein in cervical squamous cell carcinoma tissues without lymph node metastasis(62.22%) was significantly lower than that in cervical squamous cell carcinoma tissues with lymph node metastasis(93.75%)(P<0.05).Conclusion Twist is well expressed in cervical squamous cell carcinoma,and is related to tumor differentiation and lymph node metastasis.The abnormal expression of Twist,E-cadherin and N-cadherin may participate in the invasion and metastasis of cervical squamous cell carcinoma.