宫颈癌组织中ADAM-19、Ki-67的表达及临床意义

目的研究早期宫颈癌组织中去整合素基质金属蛋白酶-19（a disintegrin and metallopro-teinase，ADAM-19）、癌细胞增殖指数（Ki-67）的表达及临床意义。方法应用免疫组化sP法检测18例正常宫颈上皮（normal cervical epithelium，NCE）、22例宫颈上皮内瘤变（cervical intraepithelialneoplasm，CIN）和82例宫颈早期浸润癌（invasive cervix carsinoma，ICC）组织中ADAM-19和Ki-67的表达情况。结果在宫颈癌中ADAM-19表达于癌细胞浆和或细胞膜；Ki-67表达于细胞核。从正常宫颈上皮（normal cervical epithelium，NCE）到宫颈上皮内瘤变（cervical intraepithelial neoplasm，CIN）再到宫颈浸润癌（invasivecarsinomacervix,ICC），ADAM-19、Ki-67的阳性表达率逐步升高（P〈0．05）。ADAM-19在宫颈浸润癌中的表达与盆腔淋巴结转移、脉管浸润、间质浸润、国际妇产科联盟（FIGO）分期、组织学分级和Ki-67表达有关（P〈0．05）；但与年龄和组织学类型无明显相关性（P〉0．05）。有盆腔淋巴结转移、脉管浸润、突破深层间质浸润、FIGO分期为Ⅱ期、组织学分级为Ⅲ级及Ki-67高度表达者，其ADAM-19阳性表达率显著高于无盆腔淋巴结转移、无脉管浸润、浸润深度在浅层间质以内、FIGO分期为Ⅰ期、组织学分级未超过Ⅱ级及Ki-67表达在中度以内者（P〈0．05）。结论ADAM-19阳性表达可能在癌细胞增殖和侵袭转移中起重要作用。ADAM-19过度表达者，癌细胞增殖活跃，更易发生侵袭转移，但并非唯一决定因素。检测宫颈癌中ADAM-19表达对进一步了解宫颈癌生物学行为和判断其预后有一定价值。

The expression and clinical significance of ADAM-19,Ki-67 in cervical cancer

Objective To evaluate the expression and clinical significance of A disintegrin and metalloproteinase（ ADAM - 19 ）, Ki -67 in early invasive cervical cancer. Methods Expression of ADAM - 19 and Ki -67 in 18 cases of normal cervical epithelium（NCE） ,22 cases of cervical intraepithelial neoplasm（CIN） and 82 cases of invasive carcinoma cervix（ICC） were detected by immunohistochemistry SP method. Results ADAM- 19 was mainly expressed in the cellular membrane and/or cytoplasm in tumor cells, whereas the expression of Ki -67 was localized within the nuclei. It was demonstrated that positive rate of expression of ADAM- 19 increased remarkably from normal cervical epithelium （NCE）to cervical intraepithelial neoplasm （CIN） ,and then to invasive carcinoma cervix（ ICC ） accordingly （ P 〈 0.05 ）. In ICC, the expression of ADAM - 19 correlated with pelvic lymph node metastasis, intravascular and stromal infiltration, FIGO staging, histological grading and Ki -67 expression（ P 〈 0.05 ） ;but not correlated with patients age and histological types （P 〉 0.05 ）. In cases with pelvic lymph node metastasis, intravascular and deeper stroma infiltration, FIGO staging II and histological grading III o- ver - expression of Ki- 67, positive rate of ADAM- 19 was significantly higher than that in those without the conditions mentioned above （ P 〈 O. 05 ）. Conclution In cervical cancer, ADAM - 19 may play an important role during proliferation of tumor cells, carcinoma invasion and metastasis. Over - expression of ADAM - 19 may increase the proliferation of tumor cells and cancer progression, but it is not the only decisive factor. Early detection of ADAM - 19 may be of value in further understanding the biological behavior and predicting the prognosis ofcervical carcinoma.