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目的:分析p63蛋白、细胞色素芳香化酶P450(P450arom)及类固醇生成因子-1(SF-1)在子宫良恶性病变发病机制中的作用。方法:选取宫颈组织标本共193例,其中正常宫颈20例,慢性宫颈炎24例,宫颈上皮内瘤变(CIN)48例(CINⅠ12例,CINⅡ~Ⅲ36例),宫颈癌101例;选取同期子宫内膜组织共85例,其中正常内膜22例,不典型增生25例,子宫内膜癌38例。运用免疫组化法检测宫颈组织中p63蛋白表达和细胞增殖状程度,采用免疫组化法和半定量逆转录聚合酶链反应(RT-PCR)技术检测宫颈组织和子宫内膜组织中P450arom表达和P450arom mRNA相对含量,采用免疫组化法检查SF-1蛋白在子宫内膜组织中表达。结果:p63蛋白在CINⅡ~CINⅢ和宫颈癌中的阳性表达率和阳性表达上皮细胞数显著高于正常宫颈、慢性宫颈炎和CINⅠ,p63蛋白在宫颈癌中的阳性表达率和阳性表达上皮细胞数显著高于CINⅡ~CINⅢ(P<0.05)。P450arom在CINⅡ~CINⅢ和宫颈癌中的阳性表达率和P450arom mRNA相对含量显著高于正常宫颈、慢性宫颈炎和CINⅠ,P450arom在宫颈癌中的阳性表达率和相对含量显著高于CINⅡ和CINⅢ(P<0.05)。P450arom在不典型增生和子宫内膜癌中的阳性表达率和P450arom mRNA相对含量显著高于正常内膜,P450arom在子宫内膜癌中的阳性表达率和P450arom mRNA相对含量显著高于不典型增生(P<0.05)。SF-1蛋白在不典型增生和子宫内膜癌中的表达显著高于正常内膜,SF-1蛋白在子宫内膜癌中的表达显著高于不典型增生(P<0.05)。结论:p63蛋白、P450arom及SF-1在宫颈和/或子宫内膜中的异常表达可促进其恶性病变的发生。
PURPOSE: To analyze the role of p63 protein, cytochrome aromatase P450 (P450arom) and steroidogenic factor-1 (SF-1) in the pathogenesis of benign and malignant uterine lesions. Methods: A total of 193 specimens of cervical tissue were selected, including 20 normal cervix, 24 chronic cervicitis, 48 cervical intraepithelial neoplasia (CINⅠ12 cases, CINⅡ ~ Ⅲ36 cases) and 101 cases of cervical cancer. Endometrial tissue a total of 85 cases, of which 22 cases of normal endometrium, atypical hyperplasia in 25 cases, 38 cases of endometrial cancer. Immunohistochemistry was used to detect the expression of p63 protein and the degree of cell proliferation in cervical tissue. The expression of P450arom in cervical tissue and endometrium was detected by immunohistochemistry and semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) P450arom mRNA relative content, using immunohistochemistry SF-1 protein expression in endometrial tissue. Results: The positive expression rate and positive epithelial cell number of p63 protein in CINⅡ-CINⅢ and cervical cancer were significantly higher than those in normal cervix, chronic cervicitis and CINⅠ, p63 protein in cervical cancer and the positive expression of epithelial cells Significantly higher than CIN Ⅱ ~ CIN Ⅲ (P <0.05). The positive rate of P450arom and the relative content of P450arom mRNA in CINⅡ-CINⅢ and cervical cancer were significantly higher than that in normal cervix, chronic cervicitis and CINⅠ. The positive rate and relative content of P450arom in cervical cancer were significantly higher than those in CINⅡ and CINⅢ <0.05). The positive expression rate of P450arom and the relative content of P450arom mRNA in atypical hyperplasia and endometrial carcinoma were significantly higher than those in normal endometrium. The positive expression rate of P450arom and the relative content of P450arom mRNA in endometrial carcinoma were significantly higher than those in atypical hyperplasia P <0.05). The expression of SF-1 protein in atypical hyperplasia and endometrial carcinoma was significantly higher than that in normal endometrium, and the expression of SF-1 protein in endometrial carcinoma was significantly higher than that in atypical hyperplasia (P <0.05). Conclusion: The abnormal expression of p63, P450arom and SF-1 in cervical and / or endometrium may promote the occurrence of malignant lesions.