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目的探讨宫颈鳞癌组织埃兹蛋白(ezrin)表达与浸润转移和预后的关系。方法采用免疫组织化学SP法检测28例正常宫颈上皮(NCE)、36例宫颈上皮内瘤变(CIN)和68例宫颈鳞癌(SCC)中ezrin表达,并检测MIB1标记的增殖指数(PI)、CD34标记的微血管密度(MVD)和VEGFR-3标记的微淋巴管密度(LMVD)。结果从NCE到CIN再到SCC,ezrin表达水平显著升高(P<0.05)。ezrin在SCC中表达与FIGO分期、盆腔淋巴结转移、间质浸润及脉管浸润有关(P<0.05),而与患者年龄及组织学分级无关(P>0.05)。FIGO分期为Ⅱ期、有盆腔淋巴结转移、突破深肌层间质浸润和有脉管浸润者,ezrin表达水平显著高于FIGO分期为Ⅰ期、无盆腔淋巴结转移、浸润深度在浅肌层间质以内和无脉管浸润者(P<0.05)。从NCE到CIN再到SCC,PI、MVD和LMVD显著升高(P<0.05)。ezrin在SCC中表达与PI、MVD及LMVD均无显著相关性(P>0.05)。宫颈鳞癌组织ezrin高表达组患者生存率明显低于低表达组,但差异无统计学意义(P=0.0631)。结论 ezrin可能在宫颈鳞癌浸润转移过程中起重要作用,并可能成为一个有价值的预后标志物。
Objective To investigate the relationship between ezrin expression and infiltration, metastasis and prognosis in cervical squamous cell carcinoma. Methods Immunohistochemical SP method was used to detect ezrin expression in 28 cases of normal cervical epithelium (NCE), 36 cases of cervical intraepithelial neoplasia (CIN) and 68 cases of cervical squamous cell carcinoma (SCC). MIB1 labeled proliferation index (PI) , CD34-labeled microvessel density (MVD) and VEGFR-3-labeled micro-lymphatic vessel density (LMVD). Results From NCE to CIN to SCC, ezrin expression was significantly increased (P <0.05). The expression of ezrin in SCC was correlated with FIGO staging, pelvic lymph node metastasis, interstitial infiltration and vascular infiltration (P <0.05), but not with age and histological grade (P> 0.05). FIGO stage Ⅱ, pelvic lymph node metastasis, break through the deep interstitial infiltration and vascular invasion, ezrin expression was significantly higher than the FIGO stage Ⅰ, no pelvic lymph node metastasis, depth of invasion in the superficial layer of the mesenchyme Intra-infiltration and no vascular invasion (P <0.05). From NCE to CIN to SCC, PI, MVD and LMVD were significantly increased (P <0.05). There was no significant correlation between ezrin expression in SCC and PI, MVD and LMVD (P> 0.05). The survival rate of patients with high expression of ezrin in cervical squamous cell carcinoma was significantly lower than that of low expression, but the difference was not statistically significant (P = 0.0631). Conclusion ezrin may play an important role in invasion and metastasis of cervical squamous cell carcinoma and may be a valuable prognostic marker.