宫颈癌变过程中XIAP和caspase-3表达水平的变化及其与高危型人乳头瘤病毒感染的相关性

目的：探讨X-连锁凋亡抑制蛋白（X-linked inhibitor of apoptosis protein,XIAP）和caspase 3在宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）及宫颈鳞癌（squamous carcinoma of the cervix,SCC）中的表达水平及其与高危型人乳头瘤病毒（human papilloma virus,HPV）感染的关系.方法：采用免疫组织化学Envision二步法检测XIAP和caspase-3在SCC（n=25）、CIN（n=80）及正常宫颈（normal cervix,NC,n=10）石蜡包埋组织中的表达,并进行HPV分型检测.结果：高危型HPV 总感染率为62.6％（72/115）.SCC、CINⅢ、CINⅡ、CIN Ⅰ、NC组的高危型HPV感染率分别为88.0％（22/25）、84.0％（21/25）、68.0％（17/25）、33.3％（10/30）、20.0％（2/10）,高危型HPV感染率随着宫颈病变的加重呈上升趋势,差异有统计学意义（x2 =30.820,P =0.000）.NC、CIN Ⅰ、CINⅡ与SCC组的XIAP阳性表达率两两比较差异均有统计学意义（P均＜0.01）,XIAP阳性率及表达水平与宫颈病变的严重程度呈正相关（r=0.410,P=0.000）.NC、CIN Ⅰ、CINⅡ、CINⅢ与SCC组的caspase-3阳性表达率两两比较差异均有统计学意义（P均＜0.05）,其阳性率及表达水平与宫颈病变的严重程度呈负相关（r=-0.320,P=0.000）.在CIN及SCC中,XIAP与caspase-3、XIAP与高危型HPV感染分别呈负相关（r=-0.402,P=0.000）和正相关（r=0.458,P=0.000）.结论：高危型HPV感染、XIAP高表达和caspase-3表达下调在宫颈癌前病变向SCC演变的过程中可能起促进作用.

Changes of XIAP and Caspase-3 Levels in Cervical Carcinogenesis and Their Relationships with High-Risk Human Papilloma Virus Infection

Objective：To investigate the expression of XIAP and caspase-3 in cervical intraepithelial neoplasia （CIN）and squamous carcinoma of the cervix （SCC）,and to evaluate the relationship among high-risk human papilloma virus（HPV） infection,XIAP and caspase-3.Methods：The expression levels of XIAP and caspase-3 were detected by Envision immunohistochemical method in paraffin-embedded tissues from 25 cases of SCC,80 cases of CIN,and 10 people with normal cervix（NC）,and HPV types were detected.Results：The overall infection rate of high-risk HPV was 62.6 ％ （72/115）.The infection rate of high-risk HPV in SCC,CINⅢ,CIN Ⅱ,CIN Ⅰ,NC groups were 88.0％（22/25）,84.0％（21/25）,68.0％（17/25）,33.3％（10/30） and 20.0％ （2/1（0）,respectively.High risk HPV prevalence tended to increase with the aggravation of cervical lesion （x2 =30.820,P =0.000）.The positive expression rate of XIAP in SCC group was remarkably higher than those in NC,CIN Ⅰ,CIN Ⅱ groups （P all＜0.01）.The positive expressiog rate and expression level of XIAP increased gradually from CIN to SCC（r =0.410,P =0.000）.The positive expression rate of caspase-3 in SCC group was statistically different from those in NC,CIN Ⅰ,CIN],CIN Ⅲ groups （P all＜0.05）.The positive expression rate and expression level of caspase-3 were negatively correlated with the severity of cervical lesion（r =0.320,P =0.000）.In CIN and SCC,the expression level of XIAP was negatively correlated with that of caspase 3（r=-0.402,P =0.000）,but positively correlated with high-risk HPV infection （r =0.458,P =0.000）.Conclusions：High-risk HPV infection as well as high expression of XIAP and low expression of caspase-3 may play important roles in the carcinogenesis and development of SCC.