宫颈癌演进过程中的细胞动力学研究

目的：探讨宫颈癌演进过程中的细胞动力学特征。方法：应用增殖细胞核抗原（PCNA）的免疫组织化学技术和脱氧核糖核酸末端转移酶介导的dUTP缺口末标记（TUNEL）技术，对25例宫颈癌、15例宫颈上皮内肿瘤中增殖细胞与凋亡细胞进行分析，以10例正常宫颈上皮为对照。结果：正常宫颈上皮中增殖细胞主要位于复层鳞状上皮的基底层，凋亡细胞集中分布于复层鳞状上皮的表层；宫颈上皮内肿瘤和宫颈癌丧失上述分布特征。宫颈癌细胞增殖指数（PI）显著高于宫颈上皮内肿瘤和正常宫颈上皮（P＜0．01）；宫颈上皮内肿瘤PI显著高于正常宫颈上皮（P＜0．01）。宫颈上皮内肿瘤细胞凋亡指数（AI）显著高于宫颈癌和正常宫颈上皮（P＜0．01）；宫颈AI显著高于正常宫颈上皮（P＜0．01）。宫颈癌PI／AI比值显著高于宫颈上皮内肿瘤和正常宫颈上皮（P＜0．01）；宫颈上皮内肿瘤与正常宫颈上皮间PI／AI比值差异无显著性（P＞0．05）。结论：在宫颈上皮内肿瘤向肿瘤向宫颈癌演进过程中，增殖细胞群体随着病变恶性程度的增加而增加，凋亡细胞群体随着病变恶性程度的增加而减少，细胞增殖和细胞凋亡失衡是宫颈癌发生、发展的重要要机制之一。

A study on cell kinetics in the gradu~ progress of cervical carcinoma

Objective To investigate the characteristics of cell kinetics in the gradual progress of cervical carcinoma. Methods PCNA (Proliferating cell nuclear antigen) immunohistochemical method and TUNEL (TdT-mediated dUTP nick end labeling) technique were used to identify the prolific activity and appoptosis of cervical epithelial cells in 25 casese with cervical carcinoma. 15 cases with CIN (cervical intraepithelial neoplasia) and 10 normal cervical epithelial tissues were used as the control.Results The prolific cells were confined to the basal layer of epithelial,appoptotic cells in the superficial layers in normal cervical epithelial tissues. These characteristics of distribution were lost in cervical carcinoma and CIN. PI(proliferating index) in cervical carcinoma was significantly lugher than those of CIN and normal ( P <0.01). PI in CIN was significantly higher than that of normal ( P <0.01). AI (apoptotic indes) in CIN was significantly higher than those of cervical carcinoma and normal ( P <0.01). AI in cervical carcinoma was significantly higher than that of normal ( P <0.01). The ratio of PIAI in cervical carcinoma was significantly higher than those of CIN and normal ( P <0.01), but there were no signficant difference in the ratio of PIAI between CIN and normal ( P <0.01). Conclusion The proliferating cell colonies increased along with malignant degree of lesion and the appoptotic cell colonies decreased along with malignant degree of lesion in the gradual progress of cervical carcinoma. The imbalance of cell proliferation and appoptosis may play important role in the gradual progress of cervical carcinoma.