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目的探讨缺氧诱导因子-1α(HIF-1α)和Ras相关C3肉毒杆菌毒素底物1(Rac1)在宫颈上皮内瘤变(CIN)和鳞状细胞癌中的表达以及临床意义。方法采用免疫组织化学法检测正常宫颈组织20例、宫颈CIN 42例(CINⅠ级12例,CINⅡ~Ⅲ级30例)、宫颈鳞状细胞癌58例(高分化15例,中分化24例,低分化19例)中HIF-1α和Rac1蛋白的表达情况,以分析其表达与临床病理特征的关系,并结合临床资料进行分析。结果 HIF-1α蛋白在正常宫颈黏膜组织中的阳性表达率为0%(0/20),CINⅠ级组织阳性表达率为16.7%(2/12),CINⅡ~Ⅲ级组织阳性表达率为56.7%(17/30),宫颈鳞状细胞癌组织阳性表达率为81.0%(47/58),其中高分化阳性表达率53.3%,中分化阳性表达率83.3%,低分化阳性表达率100%。HIF-1α蛋白在宫颈鳞状细胞癌发生发展中的表达依次升高,差异具有统计学意义(P<0.05)。且宫颈鳞状细胞癌组织中HIF-1α蛋白表达与其组织学分级、TNM分期及淋巴结转移有关(P<0.05)。Rac1蛋白表达在正常宫颈黏膜组织中的阳性表达率为0%(0/20),宫颈CINⅠ级组织阳性表达率为8.3%(1/12),宫颈CINⅡ~Ⅲ级组织阳性表达率为53.3%(16/30),宫颈鳞状细胞癌组织阳性表达率为77.6%(45/58),其中高分化阳性表达率60.0%,中分化阳性表达率73.0%,低分化阳性表达率94.7%。Rac1蛋白在宫颈癌发生发展中的表达依次升高,差异具有统计学意义(P<0.05)。且宫颈鳞状细胞癌组织Rac1蛋白表达与其组织学分级、TNM分期及淋巴结转移有关(P<0.05)。HIF-1α蛋白的阳性表达率与Rac1蛋白的阳性表达率呈正相关(r=0.3,P<0.05)。结论 HIF-1α及Rac1联合检测蛋白表达有助于判断宫颈鳞状上皮肿瘤的病变程度及预后。
Objective To investigate the expression of HIF-1α (HIF-1α) and Ras-related C3 botulinum toxin 1 (Rac1) in cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (CIN) and its clinical significance. Methods Twenty cases of normal cervical tissue were examined by immunohistochemistry. Cervical CIN was detected in 42 cases (CINⅠ grade in 12 cases, CINⅡ ~ Ⅲ grade in 30 cases) and cervical squamous cell carcinoma in 58 cases (15 cases were well differentiated, 24 cases were moderately differentiated 19 cases), we analyzed the expression of HIF-1α and Rac1 protein in order to analyze the relationship between the expression of HIF-1αand Rac1 protein and clinicopathological features, and analyzed the clinical data. Results The positive expression rate of HIF-1α in normal cervical mucosa was 0% (0/20), the positive expression rate of CINⅠstage was 16.7% (2/12), the positive rate of CINⅡ-Ⅲstage was 56.7% (17/30). The positive rate of cervical squamous cell carcinoma was 81.0% (47/58). The positive rate of differentiated carcinoma was 53.3%, the positive rate of moderately differentiated tumor was 83.3%, and the positive rate of poorly differentiated tumor was 100%. The expression of HIF-1αprotein in cervical squamous cell carcinoma gradually increased, the difference was statistically significant (P <0.05). The expression of HIF-1α in cervical squamous cell carcinoma was correlated with histological grade, TNM stage and lymph node metastasis (P <0.05). The positive rate of Rac1 expression in normal cervical mucosa was 0% (0/20), the positive rate of cervical CINⅠstage was 8.3% (1/12), and the positive rate of cervical CINⅡ ~ Ⅲ was 53.3% (16/30). The positive rate of cervical squamous cell carcinoma was 77.6% (45/58). The positive rate of differentiated carcinoma was 60.0%. The positive rate of differentiated carcinoma was 73.0%. The positive rate of differentiated carcinoma was 94.7%. The expression of Rac1 protein in cervical carcinomas increased in turn, the difference was statistically significant (P <0.05). The expression of Rac1 protein in cervical squamous cell carcinoma was correlated with histological grade, TNM stage and lymph node metastasis (P <0.05). The positive rate of HIF-1α protein was positively correlated with the positive rate of Rac1 protein (r = 0.3, P <0.05). Conclusion The combined detection of HIF-1α and Rac1 protein expression is helpful to judge the degree and prognosis of cervical squamous cell carcinoma.