子宫颈病变中HPV L1蛋白和p16的表达

目的 研究HPV L1蛋白和p16在子宫颈各种病变中的表达情况,探讨它们在子宫颈病变进展中的预测价值.方法 应用免疫组化方法检测41例各种子宫颈病变(CIN1级18例、CIN2级9例、CIN3级8例和浸润性鳞状细胞癌6例)中HPV L1蛋白和p16的表达.结果 HPV L1蛋白在各种子宫颈病变中的阳性率为26.8%.其中HPV L1在CIN1中的阳性表达率为38.9%,CIN2为44.4%,CIN3和浸润性鳞状细胞癌均无表达.p16在各种子宫颈病变中的阳性率为68.3%,其在CIN1中的阳性表达率为38.9%,CIN2为77.8%,CIN3和浸润性鳞状细胞癌均表达阳性.100%CIN3和浸润性鳞状细胞癌为p16+/HPV L1-,而61.1% CIN1中为p16-/HPV L1+或p16-/HPV L1-.结论 随着子宫颈病变的进展,HPV L1阳性表达率降低而p16阳性表达率增高.p16+/HPV L1-提示子宫颈鳞状上皮内瘤变有进展的可能,而p16-/HPV L1+和p16-/HPV L1-可能为无进展的或潜在消退的子宫颈病变.     

子宫颈癌中Hedgehog信号通路蛋白表达与人乳头状瘤病毒16型感染的关系

目的 探讨Hedgehog(Hh)信号通路蛋白在宫颈癌及其癌前病变中的临床病理学意义,并分析其与人乳头状瘤病毒(HPV)16型感染的关系.方法 32例正常宫颈上皮、71例宫颈上皮内瘤变(CIN;CIN Ⅰ 28例,CIN Ⅱ 18例,CIN Ⅲ25例)和80例宫颈鳞状细胞癌共183例选自延边大学医院、延边妇幼保健院和延边肿瘤医院病理科存档蜡块.应用PCR技术检测上述组织中HPV16型的感染情况,并应用Shh、Ihh、Ptch和Smo 4种Hh信号通路蛋白抗体、组织芯片和免疫组织化学EnVision法检测Hh信号通路蛋白在上述病变组织中的表达情况.结果 Shh、Ihh、Ptch和Smo在正常宫颈黏膜上皮中为弱阳性,而在宫颈癌和CIN Ⅲ中呈强阳性,其表达率均显著高于正常宫颈黏膜上皮(P均<0.05).80例官颈癌标本中HPV16阳性率是77.5%(62/80),而且Shh蛋白的强阳性率在HPV16型阳性的宫颈癌组织中显著高于HPV16阴性组(P<0.05).结论 Hh信号通路蛋白过表达可以作为宫颈癌及其癌前病变的早期辅助诊断指标并有望成为宫颈癌靶向治疗的新靶点,而且Shh蛋白的过表达与HPV16型感染密切相关.     

子宫颈癌及癌前病变HPV16、Ki-67的表达及其相关性

目的对子宫颈癌及癌前病变中HPV感染和增殖细胞核抗原Ki-67表达情况进行研究。方法对45例子宫颈浸润性鳞状细胞癌、5例子宫颈腺癌、35例子宫颈上皮内瘤变（CIN）和5例正常宫颈组织采用免疫组化EnVision法进行HPV16和Ki-67表达的检测。结果HPV16阳性率为78．9％（71／90）,其中HPV16阳性率在子宫颈癌组织中为76．0％（38／50）,在CIN病变中为94．3％（33／35）,在正常子宫颈黏膜上皮组织中为阴性（0／5）。Ki-67阳性细胞在正常子宫颈、CIN和子宫颈癌组织中表达逐级增加,显示Ki-67表达程度与组织学类型有关。HPV和Ki-67在CIN和癌组织中的表达呈显著相关（P〈0．005）。结论瑞安地区子宫颈癌及癌前病变组织中存在HPV感染,HPV感染可能在子宫颈癌的发生、发展中起着重要作用。联合应用Ki-67与HPV可作为筛选子宫颈癌高危个体有价值的生物学标记。     

子宫颈病变中p16~(INK4A)蛋白表达及其与HPV16/18感染的关系

目的 探讨p16INK4A 蛋白在子宫颈鳞癌(SCC)和子宫颈上皮内肿瘤(CIN)中的表达及其与HPV16/18感染的关系.方法 用原位杂交法检测HPV16/18在25例子宫颈癌、45例CIN及10例慢性子宫颈炎中的表达,同时用免疫组化EliVision法检测p16INK4A 蛋白的表达.结果 (1)与慢性子宫颈炎相比,CIN Ⅱ级、CIN Ⅲ级、浸润癌HPV16/18杂交信号阳性率显著增高(P<0.01);(2)子宫颈鳞癌组织、CIN Ⅰ级、CIN Ⅱ级、Ⅲ级及慢性子官颈炎标本中p16INK4A 蛋白阳性率分别为100.0%、20.0%、46.7%、100.0%和10.0%;(3)在子宫颈鳞癌及CIN HPV16/18感染的标本中p16INK4A 蛋白表达均是阳性.结论 子宫颈鳞癌的形成与HPV感染、p16INK4A 蛋白过表达是呈正相关关系,p16INK4A蛋白可能作为子宫颈鳞癌及CIN的标志物,对子宫颈癌筛查和预防有重要意义.     

Association of the expression of the low molecular-weight protein with HPV16 infection in cervical lesions

目的 观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系.方法 以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7 mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况.结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致.在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%.临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05).(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05).在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05).结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一.     

子宫颈癌中c-myc和hMLH1表达与HPV16感染的关系

目的探讨子宫颈病变中c-myc与hMLH1和HPV16表达的关系。方法应用免疫组化SP法检测c-myc与hM-LH1在慢性子宫颈炎、子宫颈上皮内瘤变(cervical intraepi-thelial neoplasia,CIN)和子宫颈癌患者中的表达水平;PCR技术检测相应标本中HPV16感染的情况。结果 c-myc在慢性子宫颈炎、CIN、子宫颈癌中的阳性率分别为26.7%(8/30))、50%(30/60)、69.2%(36/52),差异有统计学意义(P<0.05),hMLH1阳性率依次为66.7%(20/30)、56.7%(34/60)、30.7%(16/52),差异有统计学意义(P<0.05)。在子宫颈癌组织中,c-myc蛋白与肿瘤分化程度、临床分期以及有无淋巴结转移相关;hMLH1蛋白表达下调与子宫颈癌分化程度及是否有淋巴结转移密切相关,表达差异均有统计学意义(P<0.05);HPV16与c-myc蛋白表达呈正相关;与hM-LH1蛋白表达呈负相关。结论 HPV16可能是通过影响c-myc与hMLH1蛋白表达而在子宫颈癌的发生、发展中发挥作用。     

子宫颈病变组织中低分子量蛋白酶体表达与HPV16感染的关系

目的观察低分子量蛋白酶体(low molecular-weight protein,LMP)在子宫颈病变组织中的mRNA和蛋白表达,探讨其与HPV16感染的关系。方法以152例新疆维吾尔族妇女正常子宫颈上皮、子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和子宫颈鳞癌(cervical squamous cell carcinoma,CSCC)患者为研究对象,采用RT-PCR和免疫组化法鉴定LMP2和LMP7mRNA及蛋白表达水平;采用PCR技术检测相应标本HPV16感染情况。结果 (1)LMP2、LMP7随着子宫颈病变的加重其蛋白表达逐渐降低,且mRNA表达水平与蛋白表达趋势相一致。在CIN中LMP2、LMP7蛋白表达下调和缺失率分别为25.0%/15.6%、29.7%/23.4%;在子宫颈癌中LMP2、LMP7蛋白的表达下调和缺失率分别为17.5%/34.9%、23.8%/41.3%。临床病理参数进行分析发现LMP2、LMP7与子宫颈癌分化程度及淋巴结转移密切相关(P<0.05)。(2)PCR结果显示,HPV16的检出率随着子宫颈病变的进展而增加,在慢性子宫颈炎、CIN和子宫颈癌组织中阳性率分别为8%(2/25)、67.2%(43/64)和77.8%(49/63),且随着肿瘤恶性程度的增加其阳性表达率增加,各组间阳性表达差异有统计学意义(P<0.05)。在CIN中LMP7表达下调与HPV16感染有关(P<0.05),子宫颈癌中LMP2和LMP7表达下调与HPV16感染有关(P<0.05)。结论 LMP基因的转录表达下调或蛋白质表达缺失与维吾尔族妇女子宫颈癌病变进程密切相关,其中HPV16感染可能是重要原因之一。     

子宫颈癌、子宫颈上皮内病变组织中SIRT1、HPV 16/18E6的表达及其意义

目的检测子宫颈癌及癌前病变中SIRT1的表达情况,探讨其与临床病理特征的关系。同时检测早期癌蛋白中HPV16/18E6的表达,分析两者的相关性。方法应用免疫组化En Vision法检测30例子宫颈炎、100例子宫颈上皮内病变(高级别、低级别各50例)、30例子宫颈鳞状细胞癌组织中SIRT1和HPV 16/18E6的表达。结果子宫颈癌组织中SIRT1阳性率为93.33%(28/30),高于子宫颈炎组织(13.33%,4/30),差异有统计学意义(P0.05)。子宫颈高级别上皮内病变SIRT1阳性率(88%,44/50)高于低级别上皮内病变(14%,7/50),差异有统计学意义(P0.05)。但高级别上皮内病变与子宫颈癌SIRT1阳性率差异无统计学意义(P0.05);低级别上皮内病变与子宫颈炎中SIRT1阳性率差异无统计学意义(P0.05)。在子宫颈癌中,SIRT1的阳性率与临床分期和组织学分级有关,晚期、分化差的子宫颈癌阳性率高于早期、分化好的子宫颈癌,差异有统计学意义(P0.05)。在子宫颈癌中SIRT1的阳性率(93.33%,28/30)高于HPV 16/18E6(30%,9/30),在子宫颈高级别上皮内病变中SIRT1的阳性率(88%,44/50)高于HPV 16/18E6(28%,14/50),但在低级别上皮内病变中SIRT1的阳性率(14%,7/50)低于HPV 16/18E6(36%,18/50),两者差异有统计学意义(P0.05)。结论 SIRT1的阳性率随着病变程度增加而升高,提示SIRT1与细胞恶性转变有关,其过表达可能促进上皮向高级别内病变乃至子宫颈癌进展。     

HPV E6/E7 mRNA联合HPV L1衣壳蛋白在子宫颈癌前病变诊断中的价值

目的探讨HPV E6/E7 mRNA联合HPV L1衣壳蛋白检测在子宫颈癌前病变诊断中的价值。方法采用分支链DNA信号放大技术检测156例子宫颈活检不同病变组织中HPV E6/E7 mRNA的表达,并应用免疫组化En Vision法检测HPV L1衣壳蛋白的表达。结果与正常组织相比,子宫颈低级别上皮内病变(low-grade squamous intraepithelial lesion,LSIL)、子宫颈高级别上皮内病变(high-grade squamous intraepithelial lesion,HSIL)和子宫颈鳞癌组织中HPV E6/E7mRNA的阳性率增高(P 0. 05),且HSIL和子宫颈癌中HPV E6/E7 mRNA的阳性率高于LSIL(P 0. 05),但HSIL和子宫颈癌组织中HPV E6/E7 mRNA的阳性率差异无显著性(P 0. 05); HPV L1衣壳蛋白在LSIL中的阳性率明显高于HSIL(P 0. 05)。结论通过对子宫颈不同病变标本进行HPV E6/E7 mRNA和HPV L1衣壳蛋白联合检测,了解不同病变子宫颈组织中HPV E6/E7 mRNA和HPV L1衣壳蛋白的表达趋势,可预测子宫颈上皮内病变的发展趋势,指导临床医师进行合理治疗。     

MCM4、p53在子宫颈上皮内瘤变和子宫颈癌中的表达及其临床意义

目的探讨MCM4和p53在子宫颈上皮内瘤变和子宫颈癌中的表达及其临床意义。方法采用免疫组化EliVision两步法检测48例子宫颈癌、15例CIN1、27例CIN2～3及15例正常子宫颈黏膜上皮组织中MCM4和p53蛋白的表达,并结合临床资料进行分析。结果 MCM4、p53在正常子宫颈黏膜上皮、CIN1级、CIN2～3级与子宫颈鳞癌中表达阳性率分别为6.67%、20.00%、55.56%、83.33%和0、6.67%、18.52%、41.67%,差异均有显著性(P0.05)。MCM4的表达与子宫颈鳞癌的病理学分级和临床分期有关(P0.05),与年龄分组和淋巴结转移无关(P0.05)。p53的表达与子宫颈鳞癌的病理学分级、临床分期、年龄分组和淋巴结转移均无相关(P0.05)。MCM4和p53表达无相关(P0.05)。结论 MCM4可以作为细胞增殖标志,用于子宫颈癌及其癌前病变的鉴别和诊断,并可评估肿瘤预后,指导临床治疗。     

Distribution of HPV genotypes in uterine cervical lesions in Yanbian, northern China

The aim of the present study was to investigate the distribution of HPV genotypes in uterine cervical lesions in Yanbian, northern China. HPV-DNA chip (oligonucleotide microarray) and cervical biopsy were used for 322 women in 1998-2005. All the normal cervical epithelia were negative for HPV. The positive rate of high-risk HPV was 33.9% in cervical intra-epithelial neoplasia (CIN)-1, 51.6% in CIN-2, 57.7% in CIN-3, 66.7% in cervical glandular intra-epithelial neoplasia (CGIN), 91.7% in squamous cell carcinoma (SCC), and 78.6% in adenocarcinoma. HPV-16 was the major type in all CIN and SCC cervical lesions, but in cervical adenocarcinoma HPV-18 was the most common type, and HPV-16 was the second most common type. Several cases of CIN-3, SCC and adenocarcinoma had multiple types of HPV, but there was none in CIN-1/2. In summary, HPV-16 is the type most frequently involved in the development of SCC of the cervix, and this may be helpful for the prediction of the development and progress of CIN-2/3, whereas both HPV-18 and -16 play a prominent role in the development of adenocarcinoma and CGIN of the cervix in Yanbian, northern China.     

Expression of vascular endothelial growth factor (VEGF)-C and VEGF-D, and their receptor VEGFR-3, during different stages of cervical carcinogenesis

Cervical carcinogenesis has well-defined stages of disease progression including three grades of pre-invasive lesions--cervical intraepithelial neoplasia grades 1-3 (CIN 1-3)--and invasive cervical cancer. However, the biological properties of CIN lesions prone to develop invasive disease are not well defined. Recent observations suggest that early invasive disease spreads to regional lymph nodes in several tumour types and that growth factors (VEGF-C and VEGF-D) involved in new lymphatic vessel formation may play a crucial role in this process. The present study has assessed the expression of VEGF-C and VEGF-D, and their receptor VEGFR-3, in 152 cervical lesions (33 CIN 1, 33 CIN 2, 37 CIN 3, and 49 squamous cell carcinomas) to determine whether expression of lymphangiogenic factors occurs prior to invasion. The presence of lymphatic vessels was determined using LYVE-1 and podoplanin staining, as well as double immunostaining for LYVE-1/CD34 and podoplanin/CD34. In situ hybridization was performed to determine VEGFR-3 mRNA expression. A significant positive correlation was found between VEGF-C, VEGF-D, and VEGFR-3 expression through the different stages of cervical carcinogenesis. Significant differences in protein expression for VEGF-C, VEGF-D, and VEGFR-3 were found between CIN 1-2 and CIN 3 (p<0.001 for all), but not between CIN 3 and cervical cancer. More than 50% of the CIN 3 lesions showed moderate to strong staining for VEGF-C and VEGF-D, whereas most of the early pre-cancerous lesions (CIN 1 and 2) were negative. In cervical cancer, similar observations to those in CIN 3 were found. VEGFR-3 mRNA expression was found in the cytoplasm of epithelial neoplastic cells and VEGFR3 protein expression was found in more than 50% of CIN 3 lesions and cervical cancers, compared with 15% in CIN 1 and 2. These findings suggest an autocrine growth stimulation pattern via VEGFR-3. Adjacent CIN 3 was present in nine cervical cancers and displayed strong expression for VEGF-C, VEGF-D, and VEGFR-3. These results suggest that in cervical carcinogenesis a switch to the lymphangiogenic phenotype may occur at the stage of CIN 3.     

Cyclin D1, E‐cadherin and beta‐catenin expression in FIGO Stage IA cervical squamous carcinoma: diagnostic value and evidence for epithelial–mesenchymal transition

Koay M H E, Crook M & Stewart C J R
(2012) Histopathology
Cyclin D1, E‐cadherin and beta‐catenin expression in FIGO Stage IA cervical squamous carcinoma: diagnostic value and evidence for epithelial–mesenchymal transition Aims: Immunohistochemistry is helpful in distinguishing cervical neoplastic lesions from their histological mimics, but has contributed less towards the sometimes problematic distinction of in‐situ and superficially invasive tumours. Epithelial–mesenchymal transition (EMT) may be a mechanism of invasion in cervical neoplasia and expression of EMT‐associated proteins could prove useful in this diagnostic setting. Methods and results: Immunohistochemical expression of cyclin D1, E‐cadherin and beta‐catenin was assessed in 22 biopsy specimens from FIGO Stage IA cervical squamous carcinomas, all of which also included foci of cervical intraepithelial neoplasia (CIN) 3, nine biopsies of CIN 3 adjacent to carcinoma, and 10 cases of CIN 3 only. Most invasive tumour cells expressed cyclin D1 and showed a reduction in E‐cadherin and beta‐catenin staining. Nuclear beta‐catenin expression was not observed. Cyclin D1 staining was reduced or showed altered distribution in most cases of CIN 3, while adhesion protein expression generally was preserved. However, altered protein expression similar to that of invasion was seen in some CIN lesions. Conclusions: Most superficially invasive cervical squamous carcinomas show immunophenotypical changes consistent with EMT. These alterations, particularly cyclin D1 expression, may be useful diagnostically. Similar changes in CIN 3 lesions may indicate the acquisition of increased invasive potential.     

Immunohistochemical overexpression of p16 protein associated with intact retinoblastoma protein expression in cervical cancer and cervical intraepithelial neoplasia

Both p16 and retinoblastoma (Rb) proteins are important tumor supprsssors that regulate the cell cycle. The status of both proteins In lnvasive cervical cancer and cervical intraepithelias neopiasis (CIN) has not yet been examined. The aim of this study was to investigate the expression of p16 and Rb proteins by immunohlstochemistry using 98 formalln-fixed and paraffin-embedded samples of various cervical neoplastic lesions. Strong immunoreactiyity for the p16 protein was observed in both the nuclei and cytoplasm of all CIN and lnvasive cancer cases except several low-grade CIN lesions. Expression of Rb protein was also demonatrated In the scattered nuclel of neoplastic and normal cells in all cases Investigated. The results suggest that the deletion or mutational inactivity of both p16 and Rb proteins may be a rare event In cervical carcinogenesls. Moreover, overexpression of the p16 protein may be a useful dlagnostic marker for cervical neoplastic lesions on routine laboratory screening.     

Aetiology, pathogenesis, and pathology of cervical neoplasia.

Early epidemiological studies of cervical neoplasia suggested a causal relation with sexual activity and human papillomaviruses (HPVs) have emerged as prime suspects as venerally transmitted carcinogens. HPVs fall into two broad camps: low risk types, associated with cervical condylomas and CIN 1; and high risk types (mostly 16 and 18), found in 50-80% of CIN 2 and CIN 3 lesions, and 90% of cancers. This association with cancer is very strong, with odds ratios of > 15 (often much higher) in case-control studies that are methodologically sound. An infrequently detected third group of intermediate risk type HPVs is associated with all grades of CIN and occasionally with cancers. HPVs have also been detected in a wide range of asymptomatic controls, indicating that other events are required for development of neoplasia such as viral persistence and/or altered expression of viral genes, often following integration of the viral genome. This leaves the two major viral oncogenes, E6 and E7, directly coupled to viral enhancers and promoters, allowing their continued expression after integration. High risk HPV E7 proteins bind and inactivate the Rb protein, whereas E6 proteins bind p53 and direct its rapid degradation. A range of putative cofactors has been implicated in progression: HLA type, immunosuppression, sex steroid hormones, and smoking; most of these cofactors appear to influence progression to CIN 3. The natural history includes progression to CIN 3 in 10% of CIN 1 and 20% of CIN 2 cases, whereas at least 12% of CIN 3 cases progress to invasive carcinoma. Cervical glandular intraepithelial neoplasia (CGIN) often coexists with squamous CIN, and the premalignant potential of high grade CGIN is not in doubt, but the natural history of low grade CGIN remains uncertain. A high proportion of CGIN lesions and adenocarcinomas are HPV positive, and HPV18 has been implicated more in glandular than in squamous lesions. A strong clinical case for the application of HPV typing of cells recovered from cervical scrapes can be made; however, a rigorous cost-benefit analysis of introducing HPV typing into the cervical screening programme is required. Prophylactic and therapeutic HPV vaccines are under development. This article reviews the aetiology, pathogenesis, and pathology of cervical neoplasia, emphasising the role of HPVs.     

Nucleoporin 88 expression in normal and neoplastic squamous epithelia of the uterine cervix

This study investigated the expression of nucleoporin 88 (Nup88) in formalin-fixed, paraffin-embedded archival tissues of cervical specimens consisting of normal ectocervical squamous epithelia (n = 34), low-grade squamous intraepithelial lesions corresponding to cervical intraepithelial neoplasia (CIN) 1 (n = 9), high-grade squamous intraepithelial lesions corresponding to CIN2 and CIN3 (n = 28), and invasive squamous cell carcinoma (ISCC; n = 30) to determine whether expression of this factor is involved in the progression of the morphological spectrum from normal cervical epithelia to CIN and cervical ISCC. A standard immunohistochemical technique was performed using a Ventana BenchMark XT immunostainer with a mouse antihuman monoclonal antibody to Nup88. Immunostaining was scored with regard to quantity and intensity of positively stained cells, with final immunoscores from 0 to 12 in each case. Nucleoporin 88 immunoscores increased significantly from normal ectocervical squamous epithelia to CIN1, CIN2/3, and ISCC (P < .0001, analysis of variance). Cervical intraepithelial neoplasia 2/3 as isolated lesions and adjacent to ISCC did not differ significantly. A significant correlation was noticed for immunoscores of CIN2/3 adjacent to ISCC and the corresponding ISCC (P = .0007). This study indicates that Nup88 is significantly overexpressed in high-grade CIN lesions and ISCC compared with normal ectocervical squamous epithelia and CIN1. However, Nup88 evaluation is of limited value as a diagnostic marker in individual cases.     

Increased expression of claudins in cervical squamous intraepithelial neoplasia and invasive carcinoma

Claudins (CLDNs), of which 24 types have been identified, are integral transmembrane proteins of the tight junctions that are critical for maintaining cell adhesion and polarity. They also act as selective barriers. Cells and tissues are characterized by individual CLDN patterns; the composition and levels of expression change during differentiation and tumor formation. Alterations in the expression of individual CLDNs have been detected in several carcinomas and shown to be related to progression and invasion; however, their role in carcinogenesis is controversial. Using a panel of polyclonal (CLDNs 1, 3, and 7) and monoclonal (CLDNs 2 and 4) antibodies, CLDN pattern and expression were studied by immunohistochemistry in 105 cervical tissue specimens, including normal epithelia (n = 20), cervical intraepithelial neoplasias (CINs; CIN 1/2, n = 27; CIN 3, n = 10), carcinoma in situ (CIS, n = 15), and 33 squamous keratinizing and nonkeratinizing invasive carcinomas. No CLDN 3 was observed in normal or intraepithelial neoplastic cells, but significantly increased expression of CLDNs 1, 2, 4, and 7 was detected in the CIN/CIS lesions and invasive carcinomas compared with the normal tissues (P < .001) and reduced reactivity of CLDNs 1 and 2 was observed in invasive cervical cancers compared with CIN 3/CIS (P = .0001) and of CLDNs 2, 4, and 7 compared with CIN 1/2. These results indicate increased expression of CLDNs in the early phase of carcinogenesis in intraepithelial lesions, which decreases during progression to invasive disease. Expression of CLDN 1 was strongest in premalignant stages; thus, it may serve as a good diagnostic marker for the detection of CIN.     

Telomerase in (pre)neoplastic cervical disease

This study was performed to determine upregulation of the human telomerase RNA component (hTR) and mRNA of the catalytic subunit of telomerase (hTERT) in (pre)malignant cervical lesions, to analyze possible intralesional heterogeneity of hTR expression, and to relate hTR and hTERT mRNA levels to telomerase activity levels and human papillomavirus (HPV) typing. hTR expression was determined by in situ hybridization (ISH) on paraffin-embedded sections, obtained from patients with cervical intraepithelial neoplasia (CIN) I-III or cervical cancer and from normal controls. hTR and hTERT mRNA expression were determined by semiquantitative rt-PCR on frozen samples from the same lesions. Data on telomerase activity and HPV were obtained from a previous study. hTR expression as determined by ISH was observed in 0 of 8 normal cervices, 1 of 14 CIN I, 15 of 28 CIN II, 21 of 30 CIN III, and 16 of 18 cervical cancer specimens. In general, hybridization patterns for hTR expression were homogeneous throughout the lesion. Frequency of hTR expression was related to grade of CIN/cervical cancer (P<.001). hTR expression, as determined by rt-PCR, was detected in 8 of 8 normal cervices, 2 of 2 CIN I, 12 of 14 CIN II, 23 of 23 CIN III, and 16 of 17 cervical cancer specimens. hTERT mRNA was detected in 1 of 8 normal cervices, 1 of 2 CIN I, 5 of 14 CIN II, 14 of 23 CIN III, and 11 of 17 cervical cancer specimens. hTR as determined by rt-PCR was not related to grade of CIN/cervical cancer, whereas hTERT mRNA expression was related to grade of CIN/cervical cancer (P<.01). hTR expression, as determined by ISH and hTERT mRNA expression by rt-PCR, were related to telomerase activity levels (P<.001, P<.05, respectively) and presence of oncogenic types of HPV (both P<.05). Our data show frequent upregulation of hTR and hTERT mRNA expression in CIN lesions, which appear to occur earlier than induction of telomerase activity. The fact that semiquantitative hTERT mRNA as well as hTR levels are related to telomerase activity levels illustrates that in (pre)malignant cervical lesions upregulation of both telomerase components may be important for functional telomerase.     

GLUT1 messenger RNA and protein induction relates to the malignant transformation of cervical cancer

We studied whether induction of glucose transporters (GLUTs) 1 to 4 correlates with human papillomavirus (HPV)-dependent malignant transformation of cervical epithelium. Tissue samples of cervical intraepithelial neoplasia (CIN; grades 1 to 3), invasive carcinomas, and lymph node metastasis were examined. HPV typing was performed. Tissue sections were immunostained with GLUT1 to GLUT4 antibodies. Messenger RNA (mRNA) in situ hybridization confirmed GLUT1 protein expression. Weak expression of GLUT1 was found in nondysplastic HPV-positive and HPV-negative epithelium; significant expression was observed in preneoplastic lesions, correlating with the degree of dysplasia. In CIN 3 high-risk HPV lesions, cervical cancer, and metastasis, GLUT1 was expressed at highest levels with a strong correlation of GLUT1 mRNA and protein expression. Immunostains for GLUT2 to GLUT4 were negative. Cervical tumor cells respond to enhanced glucose utilization by up-regulation of GLUT1. The strong induction of GLUT1 mRNA and protein in HPV-positive CIN 3 lesions suggests GLUT1 overexpression as an early event in cervical neoplasia. GLUT1 is potentially relevant as a diagnostic tool and glucose metabolism as a therapeutic target in cervical cancer.