宫颈癌组织中Fas、FasL及caspase-8表达及其临床意义

目的 研究Fas、FasL及caspase-8蛋白在宫颈癌组织中的表达及其临床意义，并探讨其在宫颈肿瘤细胞免疫逃避中的作用。方法 采用免疫组化法检测52例宫颈癌、18例宫颈上皮内瘤祥病变组织(CIN)及其肿瘤浸润淋巴细胞(TIL)，10例慢性宫颈炎，10例正常宫颈上皮中Fas、FasL和caspase-8蛋白表达情况。结果 Fas及FasL在宫颈癌组织中的表达率与慢性宫颈炎及正常组织比较有显著性差异(P＜0．05，P＜0．01)，宫颈鳞癌明显高于宫颈腺癌(P＜0．05，P＜0．01)。Fas阳性表达率随着组织学分级的升高而降低，FasL则增高(P＜0．01)；有淋巴结转移者FasL阳性表达率高于无淋巴结转移者(P＜0．01)；Fas及FasL表达与患者年龄、临床分期无关(P＞0．05)。宫颈癌TIL的Fas及FasL表达明显高于CIN(P＜0．01)；caspase-8在宫颈癌组织中的表达明显低于正常宫颈上皮及慢性宫颈炎组织(P＜0．01)，caspase-8表达与宫颈癌患者年龄，临床分期，组织学类型无关(P＞0．05)，有淋巴结转移者明显低于无淋巴结转移者(P＜0．05)，随着组织学分级的降低，caspase-8表达亦明显降低，但无显著性差异。结论 宫颈癌能通过Fas，caspase-8低表达及FasL高表达，逃避机体免疫监视以促使肿瘤发生发展及转移。

Expression of Fas,FasL and Caspase-8 in Cervical Carcinoma and its Clinical Significance

Objective To investigate the expression of Fas,Fas ligand,caspase-8 and its clinical significance in cervical carcinoma and explore the effect of Fas system in the mechanism of tumor immune evasion.Methods Immunohistochemical method was used to detect the expression of Fas,FasL and caspase-8 in 52 samples of cervical carcinoma,18 samples of cervical intraepithelial neoplasia(CIN),10 samples of chronic cervicitis and 10 samples of normal cervical tissues.Results The expression of Fas and FasL were significantly different between cervical carcinoma and chronic cervicitis tissues or normal cervix(P<0.05,P<0.01),The expression of Fas and FasL were significantly higher in squamous cell carcinoma than in adenocarcinoma(P<0.05,P<0.01).There was a significant correlation between the expression of Fas,FasL and histologic grades(P<0.01).The more poorly the tumor was differentiated,the higher the expression rate of FasL was and the lower the expression rate of Fas was.The expression of FasL increased in tumor with lymphnode metastases compared with tumor without(P<0.01).There was no significant relationship between the expression of Fas,FasL and the age of patient or the clinical staging.The expression of Fas and FasL in TIL around cervical carcinoma was higher than that in CIN(P<0.01).There was no correlation between caspase-8 expression and histological type,age of patient or clinical staging.Caspase-8 expression rate was lower in cervical carcinoma than in chronic cervicitis tissues and normal cervix(P<0.01).The expression of caspase-8 in cervical carcinoma was lower in tumor with lymph node metastases than in tumor without.The expression of caspase-8 was higher,though insignificantly,in highly differentiated tissue than in lowly differentiated tissue.Conclusion The low expression of Fas and caspase-8 and high expression of FasL may contribute to the carcinogenesis and development of cervical carcinoma by evading the host immune surveillance.