survivin、bcl-2在宫颈癌和癌前病变组织中的表达及与人乳头瘤病毒16/18感染的相关性

目的 探讨宫颈癌中survivin、bcl-2、人乳头瘤病毒(HPV)16/18的表达及其相关性.方法 采用原位杂交法检测74例宫颈上皮内瘤变(CIN)、81例宫颈癌及20名正常宫颈组织(对照组)中survivin mRNA及HPV16/18 DNA的表达.采用免疫组织化学法检测各组中bcl-2蛋白的表达.结果 survivin mRNA、bcl-2蛋白及HPV16/18在CIN中的表达率分别为44.6%、39.2%和41.0%,在宫颈痛中的表达率分别为77.8%、70.4%和81.2%.3者在正常宫颈组织、CIN及宫颈癌中的表达呈逐渐增强(P＜0.01).survivin mRNA、bcl-2蛋白在CINⅢ级的阳性表达率高于CIN I～Ⅱ级,在宫颈癌中,Ⅱb～Ⅲ期的阳性表达率高于Ⅰ～Ⅱ a期,低分化组的阳性表达率高于中至高分化组,差异均有统计学意义(均P分别＜0.05,＜0.01).survivin在有淋巴结转移组的阳性率显著高于无转移组(P＜0.01),而bcl-2的表达则与淋巴结转移无关.两者均与宫颈癌的病理类型、肿块类型无关,HPV16/18感染与宫颈癌临床分期、组织学分级及肿块类型无关(P＞0.05).在宫颈癌中survivin与bcl-2的表达与生存率均呈负相关,survivin与bcl-2及survivin与HPV16/18的表达呈正相关.结论 survivin、bcl-2及HPV16/18的异常表达参与了宫颈癌的发生发展,联合survivin、bcl-2、HPV16/18有望为宫颈恶性肿瘤的早期诊断、手术及化疗疗效的评价、预后的判断提供有力的临床指导.

Expression of survivin,bd-2 in cervical carcinoma and its association with HPV16/18 infection

Objective To investigate the expression and the correlation of surviving,bcl-2 and HPV16/18 in cervical carcinoma.Methods Hybridization in situ was used to detect the expression of survivin mRNA and HPV16/18 DNA in 74 cases of CIN and 81 cases of cervical carcionma and 20 cases of normal cervical tissues.And immunohistechemical analysis was used to detect the expression of bcl-2 protein.Results The positive rates of survivin mRNA,bcl-2 and HPV16/18 in CIN were 44.6%,39.2% and 41.0% respectively versus 77.8%,70.4% and 81.2% in cervical carcinoma.The above three indices gradually rose in normal cervical tissue,CIN and cervical carcinoma.The expression of survivin and bcl-2 in CIN Ⅲ were obviously higher than those in CIN Ⅰ/Ⅱ.And it was obviously higher in cervical carcinoma with stage Ⅱ b-Ⅲ than those in stage Ⅰ-Ⅱ a.And it was also obviously higher in cervical carcinoma with a poor differentiation than those with a good or medium differentiation.The expression of survivin in cervical carcinoma with lymphatic metastasis was significantly higher than that without Lymphatic metastasis.There were no relationship between the expression of survivin or bcl-2 and the pathological type or tumor type of cervical carcinoma.The infection of HPV16/18 also had nothing to do with the clinical stage or pathological type or tumor type of cervical carcinoma.Inverse correlation was both observed in the expression of survivin and bcl-2 with survival rate.Thus a positive correlation between surviving,bcl-2 and HPV 16/18 was observed in cervical carcinoma.Conclusion Survivin,bcl-2 and HPV16/18 participate in the development of cervical carcinoma.It may be a useful guide in early diagnosis of cervical carcinoma,evaluation of surgery and chemotherapy and prediction of outcome.