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目的探讨脆性组氨酸三联体基因(FHIT)表达缺失或下降和p53的过度表达在宫颈癌发生发展中的意义。方法2001年1月至2003年1月温州医学院附属第一医院采用免疫组化SP法检测52例宫颈上皮内瘤样病变(CIN)和69例宫颈浸润癌组织中的FHIT基因和p53的表达,并以18例慢性宫颈炎组织为对照。结果FHIT在慢性宫颈炎组织中呈100%表达。在宫颈CINⅠ、Ⅱ、Ⅲ的下降或缺失率分别占9.1%、29.4%和41.7%。在宫颈浸润癌中的下降或缺失率占66.7%,其中鳞癌低表达率为75.4%,较腺癌的25.0%差异有显著性意义(P<0.01),临床Ⅰ、Ⅱ期和Ⅲ或Ⅳ期的缺失率分别为60.7%、65.2%和77.8%,组织学分级G1、G2和G3的缺失率分别为47.4%、64.3%和86.4%,临床Ⅰ、Ⅱ期与Ⅲ或Ⅳ期比较,组织学分级G1及G2与G3比较差异均有显著性意义(P<0.05)。p53在慢性宫颈炎组织无表达,在宫颈浸润癌中呈56.5%阳性表达,且随着临床期别的增高、细胞分化的降低以及淋巴转移的出现进一步上升。p53阳性的宫颈癌中FHIT缺失为74.4%,而p53阴性的FHIT缺失占56.7%,两者比较差异无显著性意义(P>0.05)。结论FHIT基因下降或缺失与p53过度表达是宫颈癌的频发事件,测定宫颈CIN中FHIT可作为宫颈癌的高危人群筛选指标,FHIT与p53检测还可作为宫颈癌的预后指标。
Objective To investigate the significance of the deletion or decrease of the expression of FHIT gene and the overexpression of p53 in the development of cervical cancer. Methods From January 2001 to January 2003, the first affiliated hospital of Wenzhou Medical College detected the expression of FHIT gene and p53 in 52 cases of cervical intraepithelial neoplasia (CIN) and 69 cases of invasive cervical carcinoma by immunohistochemical SP method , And 18 cases of chronic cervicitis as control. Results FHIT was 100% expressed in chronic cervicitis tissues. Cervical CIN Ⅰ, Ⅱ, Ⅲ decreased or missing rates accounted for 9.1%, 29.4% and 41.7%. In invasive cervical cancer, the rate of decline or deletion accounted for 66.7%, of which the low expression rate of squamous cell carcinoma was 75.4%, which was significantly different from that of adenocarcinoma (25.0%) (P <0.01). The clinical stage Ⅰ, Ⅱ and Ⅲ or Ⅳ The deletion rates of the two groups were 60.7%, 65.2% and 77.8%, respectively. The loss rates of histological grade G1, G2 and G3 were 47.4%, 64.3% and 86.4% respectively. Compared with those in stage Ⅲ or Ⅳ, There were significant differences in grade G1, G2 and G3 (P <0.05). p53 was not expressed in chronic cervicitis tissues, and 56.5% was positive in invasive cervical carcinoma. With the increase of clinical stage, the decrease of cell differentiation and the occurrence of lymphatic metastasis further increased. FHIT deletion in p53-positive cervical cancer was 74.4%, while p53-negative FHIT deletion was 56.7%. There was no significant difference between the two groups (P> 0.05). Conclusions The decrease or deletion of FHIT gene and p53 overexpression are frequent events of cervical cancer. FHIT can be used as a screening index for high risk population of cervical cancer in cervical CIN, and FHIT and p53 can be used as prognostic indicators of cervical cancer.