Skp2和p27在宫颈癌组织的表达及临床意义

目的:探讨Skp2、p27在宫颈癌的表达、两者的相关性,以及与临床病理因素和预后的关系。方法:用免疫组化SP法检测65例宫颈鳞状细胞癌(SCC),20例高级别宫颈上皮内瘤变(CIN)中Skp2、p27的表达,以60例正常宫颈组织(NCT)为对照。结果:(1)Skp2在SCC组的阳性表达率为55.4%,明显高于高级别CIN组的25.0%(P0.05)及NCT组的6.7%(P0.01);(2)p27在SCC组的阳性表达率为52.3%,明显低于高级别CIN组的85.0%(P0.01)及NCT组的98.3%(P0.01);(3)半定量分析表明SCC中Skp2、p27表达与年龄、肿瘤大小、临床分期无明显关系(P0.05),而与肿瘤的病理分级、浸润深度、脉管浸润、淋巴结转移密切相关(P0.05);(4)宫颈癌中Skp2阳性表达组的5年生存率(52.78%)明显低于Skp2阴性组(68.93%),Kaplan-Meier生存率分析,Log-rank=8.60,P=0.0034。而p27阳性表达组的5年生存率(70.59%)明显高于阴性表达组(58.38%),Log-rank=8.33,P=0.0039;经Spearman等级相关分析表明,宫颈癌中Skp2和p27的表达呈显著负相关,相关系数r=-0.311,P=0.015。结论:Skp2表达增强与宫颈癌的发生、发展密切相关,其表达水平越高提示患者预后越差;p27的表达正相反,并且两者的表达呈负相关。联合检测Skp2和p27的表达对判断宫颈癌的恶性潜能和预后具有重要的参考价值;两者可作为宫颈癌的预后指标,为宫颈癌的治疗提供新的靶点。

Expression of Skp2 and p27 protein and their clinical significance in cervical carcinoma

Objective:To study the expression and correlation of Skp2 and p27 in squamous cell carcinoma of cervix and their relationships with clinicopathological features and prognosis.Methods:Immunohistochemical SP technique was used to detect the expressions of Skp2 and p27 in 65 cases of squamous cell carcinoma of cervix(SCC) and 20 cases of cervical intraepithelial neoplasia(CIN).60 cases of normal cervical tissue(NCT) were taken as control group.Results:(1)The rate of positive expression of Skp2 in cervical carcinoma was 55.4%,significantly higher than that of 25.0% in CIN (P<0.05) and that of 6.7% in normal cervical tissue(P<0.01).(2)The rate of positive expression of p27 in cervical carcinoma was 52.3%,significantly lower than that of 85.0% in CIN(P<0.01) and that of 98.3% in normal cervical tissue(P<0.01).(3)The expression levels of Skp2 and p27 were independent of age,tumor size and clinical stage(P>0.05),but significantly associated with grade,tumor infiltration depth,intravascular involvement and lymph node metastasis of cervical carcinoma.(4)Kaplan-Meier survival rates analysis showed the 5-year survival rates of cervical carcinoma in Skp2 expression positive group (52.78%) were remarkably lower than that of Skp2 negative group(68.93%)(Log-rank=8.60,P=0.0034).5-year survival rates of cervical carcinoma in positive p27 expression group (70.59%) was remarkably higher than that of p27 negative group (58.38%),Log-rank=8.33,P=0.0039.Spearman's rank correlation test showed that Skp2 expression in cervical carcinoma had negative correlation with p27 expression.Correlation coefficient:r=-0.311,P=0.015.Conclusions:Overexpression of Skp2 may play an important role in the development and progression of cervival carcinoma,the higher expression levels indicates poorer prognosis,while a negative correlation is observed between the expression of Skp2 and p27.Combined detection of the expressions of Skp2 and p27 have an important value in the evaluation of malignant potential and prognosis of cervical carcinoma.Skp2 and p27 can be used as the indicators for the prognosis of cervical carcinoma and provide a new target to the treatment of cervical carcinoma.