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目的:检测宫颈癌组织中微小染色体维持蛋白-5(minichromosome maintenance protein 5,MCM5)与P16INK4AmRNA的表达,并探讨其在宫颈癌中的临床意义。方法:采用实时荧光定量PCR(real-time PCR)检测40例宫颈鳞状细胞癌、15例低度宫颈上皮内瘤变(CINⅠ)、20例高度宫颈上皮内瘤变(CINⅡ-Ⅲ)中MCM5和P16INK4AmRNA的相对表达量,并以20例正常宫颈组织作为对照,分析其与宫颈癌临床病理特征的关系。结果:(1)随着宫颈病变程度的加重,MCM5和P16INK4AmRNA的表达量逐渐增高。宫颈癌组织中MCM5和P16INK4AmRNA的表达量分别是正常宫颈组织的(3.026±1.210)倍和(2.540±0.718)倍,差异具有统计学意义(P<0.05)。宫颈癌组织中MCM5 mRNA的表达量明显高于CINⅠ、CINⅡ-Ⅲ(P<0.05),CINⅠ、CINⅡ-Ⅲ中MCM5 mRNA的表达量均显著高于正常宫颈组织,差异具有统计学意义(P<0.05),而CINⅠ与CINⅡ-Ⅲ比较差异无统计学意义(P>0.05);宫颈癌组织中P16INK4AmRNA的表达量为正常宫颈组织的(2.54±0.86)倍,差异有统计学意义(P<0.05),亦显著高于CINⅠ,差异具有统计学意义(P<0.05),但与CINⅡ-Ⅲ比较差异无统计学意义(P>0.05)。(2)在宫颈癌组织中,MCM5 mRNA的表达量与肿瘤的临床期别、分化程度显著相关(P<0.01),但与患者的年龄无关(P>0.05);P16INK4AmRNA的表达量与肿瘤的临床期别、年龄均无关(P>0.05),但与肿瘤的分化程度相关(P<0.01)。结论:MCM5、P16INK4A的高表达可能在宫颈癌的发展中起重要作用。MCM5基因检测有助于区分癌前病变和宫颈癌,有望成为宫颈癌肿瘤增生的新标志物。P16INK4A的检测在宫颈病变筛查中具有重要意义,有助于CIN的分级并预测转归,从而提高宫颈癌筛查率。
Objective: To detect the expression of minichromosome maintenance protein 5 (MCM5) and P16INK4A mRNA in cervical cancer and to investigate its clinical significance in cervical cancer. Methods: Forty cases of cervical squamous cell carcinoma, 15 cases of low grade cervical intraepithelial neoplasia (CINⅠ) and 20 cases of high grade cervical intraepithelial neoplasia (CINⅡ-Ⅲ) were detected by real-time PCR. MCM5 And P16INK4A mRNA relative expression, and 20 cases of normal cervical tissue as a control, analyze the relationship with clinicopathological features of cervical cancer. Results: (1) With the increase of cervical lesions, the expression of MCM5 and P16INK4A mRNA gradually increased. The expression levels of MCM5 and P16INK4A mRNA in cervical cancer tissues were (3.026 ± 1.210) and (2.540 ± 0.718) times higher than those in normal cervical tissues, respectively. The difference was statistically significant (P <0.05). The expression of MCM5 mRNA in cervical cancer tissues was significantly higher than that in CINⅠ and CINⅡ-Ⅲ (P <0.05), and the expression of MCM5 mRNA in CINⅠ and CINⅡ-Ⅲ was significantly higher than that in normal cervical tissues (P < 0.05), while there was no significant difference between CINⅠ and CINⅡ-Ⅲ (P> 0.05). The expression of P16INK4A mRNA in cervical cancer was 2.54 ± 0.86 times of that in normal cervical tissue (P <0.05) ), But also significantly higher than that of CINⅠ (P <0.05). However, there was no significant difference compared with CINⅡ-Ⅲ (P> 0.05). (2) In cervical cancer, the expression of MCM5 mRNA was significantly correlated with the clinical stage and differentiation (P <0.01), but not with the age of the patients (P> 0.05). The expression of P16INK4A mRNA was correlated with tumor Clinical stage and age (P> 0.05), but correlated with the degree of tumor differentiation (P <0.01). Conclusion: The high expression of MCM5 and P16INK4A may play an important role in the development of cervical cancer. MCM5 gene test can help distinguish precancerous lesions and cervical cancer, is expected to become a new marker of cervical cancer. The detection of P16INK4A is of great significance in the screening of cervical lesions, contributes to the classification of CIN and prognosis of prognosis, so as to improve the screening rate of cervical cancer.