中期因子在宫颈病变中的表达及与血清中期因子变化的关系

目的探讨中期因子（midkine，MK）与宫颈癌患者临床病理特征之间的关系，并为血清中期因子（sMK）作为宫颈癌早期诊断及病情监测的指标提供理论依据。方法对慢性宫颈炎组织、宫颈上皮内瘤变（CIN）组织、宫颈癌组织标本各20例进行免疫组化染色，分析各组织中MK的表达情况及与宫颈癌患者临床病理特征的关系。用酶联免疫吸附试验检测患者外周血sMK浓度，分析sMK浓度与宫颈癌患者临床病理特征的关系。结果MK在慢性宫颈炎组织中不表达，在CIN III级、宫颈癌组织中阳性表达率较高，且宫颈癌组织中MK表达水平与患者年龄、淋巴结转移无关，与临床分期、组织学分级、肿瘤直径、腺体浸润有关（P〈0．05或P〈0．01）。宫颈癌患者外周血sMK浓度明显高于慢性宫颈炎及CIN患者。宫颈癌患者sMK浓度与患者年龄、淋巴结转移无关（P〉0．05），与临床分期、组织学分级、肿瘤直径、腺体浸润有关（P〈0．05或P〈0．01）。宫颈癌患者sMK浓度与组织中MK表达水平呈正相关。结论MK可能在宫颈癌的发生过程中起到重要作用；sMK能够可靠地反映组织中MK蛋白表达情况，可作为一种用于宫颈癌诊断、病情监测的新的肿瘤标志物。

Study on expression of midkine in cervical lesions and its relationship with serum midkine levels

Objective To detect the expressions of midkine （MK） in cervical carcinoma tissues, measure the MK level in the serum of patients with primary cervical carcinoma, study their relations to the biological characteristics of primary cervical carcinoma. Methods Specimens were taken from 20 patients with chronic cervicitis, 20 patients with cer- vical intraepithelial neoplasia and 20 cervical carcinoma tissues. The tissues were analysed with the methods of immunohistochemistry, in order to analyse the correlation between their expressions and clinical pathologic features of patients with primary cervical carcinoma. ELSIA technique was used to measure serum concentration of MK in the 60 patients, so as to analyse the correlation between the serum MK level of cervical carcinoma patients and the clinical pathologic characteristics and prognosis. Results No specific positivity was detected in chronic cervicitis tissues. Positive expression of MK were detected in cervical carcinoma tissues. In cervical cancer tissues, the expression of MK was associated with clinical pathological parameters, clinical stage and FIGO stage, but was not related to age and lymphatic metastasis. The serum concentration of MK in the patients with cervical carcinoma was significantly higher than that in CIN and chronical cervi- citis patients. The serum level of MK was not related to age and lymph node metastasis, but was associated with clinical pathological parameters and clinical stage. Positive correlation between the level in the serum and the expression of MK was observed in the patients of cervical carcinoma. Conclusion MK may play an important role in progress from CIN to cervical carcinoma. With the cervical cancer regression model, the serum MK level may be considered as an prognosis factor in the patients with cervical carcinoma.