E-cadherin和Vimentin表达与早期宫颈癌临床病理特征及预后的关系

目的 探讨早期宫颈鳞癌组织中上皮间质转化相关因子E-钙黏蛋白（E-cadherin）和波形蛋白（Vimentin）的表达与临床病理特征及预后的关系。方法 采用免疫组化SP法检测E-cadherin和Vimentin在50例Ⅰb～Ⅱa期宫颈鳞癌术后标本中的表达情况，分析两者与年龄、FIGO分期、分化程度、深肌层浸润、淋巴结转移、脉管瘤栓和宫旁浸润等临床病理特征的关系，并探讨其对预后的评估价值。结果 宫颈鳞癌组织中E-cadherin 高表达率为44.0％，Vimentin 阳性率为36.0％。E-cadherin表达与分化程度和脉管瘤栓密切相关（P＜0.05），Vimentin表达与淋巴结转移情况和分化程度密切相关（P＜0.05）。单因素分析显示，宫颈鳞癌5年生存率与淋巴结转移、深肌层浸润及E-cadherin表达情况密切相关（P＜0.05）； Vimentin 阴性表达者的5年生存率高于阳性者（87.4％ vs. 72.2％），差异无统计学意义（P＞0.05）。Cox多因素分析显示E-cadherin表达和淋巴结转移是影响早期宫颈癌患者5年生存率的独立因素（P＜0.05）。结论 E-cadherin和Vimentin表达程度与早期宫颈癌侵袭转移相关；E-cadherin表达、淋巴结转移是影响早期宫颈癌患者5年生存率的独立预后因素。

Expressions of E-cadherin and vimentin in early stage cervical cancer and its correlation with clinicopathologic features and prognosis

Objective To investigate the prognostic value of E-cadherin and vimentin in early squamous cervical carcinoma and its correlation with clinicopathologic features. Methods Fifty samples of cervical squamous carcinoma from patients who received radical resection were collected. The expressions of E-cadherin and vimentin were detected by immunohistochemistry. The prognostic value of EMT markers and its relationship with clinicopathologic features in early（stage Ⅰb-Ⅱa） cervical cancer was analyzed. Results The high-expressed rate of E-acadherin in cervical cancer was 44.0%, and the positive rate of vimentin was 36.0%. The expression of E-cadherin was closely associated with pathologic differentiation degree and lympho vascular space invasion（LVSI）（P＜0.05）， while vimentin was related to pathologic differentiation degree and lymph node metastasis （P＜0.05）. Univariate survival analysis showed that lymph node metastasis， depth of myometrial invasion and E-cadherin significantly associated with overall survival （P＜0.001， P=0.037， P=0.028）. Patients with positive expression of vimentin demonstrated a trend of unfavorable prognosis， which had a 5-year survival rate of 72.2％ compared with 87.4％ in those patients with negative vimentin expression （P=0.136）. Cox proportional hazards regression showed that lymph node metastasis and E-cadherin were independent prognostic factors of 5-year overall survival （P=0.037， P=0.014）. Conclusion The gain of E-cadherin and the loss of vimentin known as “EMT” play a crucial role in tumor cell invasiveness and metastasis. E-cadherin and lymph node metastasis were independent prognostic factors for 5-year overall survival.