【摘要】 目的探讨上皮间质转化(EMT)与转录因子Twist及Snail在宫颈鳞状上皮病变发生发展过程中的作用及意义。方法选择荆州市妇幼保健院2005年1月至2009年12月宫颈组织活检及手术切除中,确诊为宫颈鳞状上皮病变的170例存档石蜡块标本为研究对象。其中,慢性宫颈炎标本为20例,纳入慢性宫颈炎标本组;CINⅠ,CINⅡ,CINⅢ及宫颈鳞癌标本各为32例,27例,35例及56例,分别纳入CINⅠ组,CINⅡ组,CINⅢ组及宫颈鳞癌组。采用原位杂交(ISH)技术及免疫组化SABC法检测170例宫颈鳞状上皮病变标本中Twist,Snail,E-cadherin及Vimentin的表达,并进行相关性分析(本研究遵循的程序符合荆州市妇幼保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与患者签署临床研究知情同意书)。结果慢性宫颈炎→CIN→宫颈鳞癌的发生发展中,E-cadherin的表达逐渐减弱,而Vimentin,Twist及Snail的表达逐渐增强,其中E-cadherin,Vimentin在宫颈鳞癌组及CINⅢ组中的表达与慢性宫颈炎组比较,差异有统计学意义(P<0.05);宫颈鳞癌组中,Twist及Snail的阳性率明显高于其他各组,差异有统计学意义(P<0.05),并且Twist及Snail的表达分别与E-cadherin呈负相关关系(P<0.05),而Twist与Vimentin则呈正相关关系(P<0.05)。结论宫颈组织中,E-cadherin表达下调,而Twist,Snail及Vimentin表达上调,这可能是宫颈鳞癌发生的重要分子生物学标志。Twist及Snail可能通过协同介导EMT的发生,促进宫颈鳞状上皮病变的发生发展,最终导致宫颈鳞癌发生。更多还原

【Abstract】 Objective To study the effects of epithelial-mesenchymal transition(EMT) and transcription factors of Twist and Snail during the genesis and development of cervical squamous epithelial lesions. Methods From January 2005 to December 2009, a total of 170 cases of file paraf fin tissue blocks of cervical squamous epithelial lesions in Jingzhou Maternal and Child Health Hospital were selected into this study. Among them, 20 cases of chronic cervicitis were included into chronic cervicitis group, 32 cases,27 cases,35 cases and 56 cases cerv ical intraepithelial neoplasia(CIN)Ⅰ,Ⅱ,Ⅲ and cervical squamous carcinom a were included into CINⅠgroup, CINⅡgroup,CINⅢ group and cervical squamous carcinoma group,respectively. Expression of Twist, Snail,E-cadherin and Vimenti n in these samples were analyzed by in situ hybridization (ISH) and SABC immunohistochemical stain. Results With the process of chronic cervicitis to CIN to cervical squamous carcinoma, expression of E-cadherin was decreasing gradually,and the expression of Vimentin,Twist and Snail were incre asing gradually. Expression difference of E-cadherin and Vimentin between the c hronic cervicitis group and the cervical squamous carcinoma group (or CINⅢ grou p) were obvious (P<0.05, respectively).The positive rates of Twist and Snail in the cervical squamous carcinoma group were higher than those in other groups (P<0.05). The expression of Twist and Snail were negatively correlated with E-cadherin respectively(P<0.05), and Twist was positively correlated with Vimentin(P<0.05). Conclusions The down-regulation of E-cadherin and the up-re gulation of Vimenti n,Twist and Snail in cervix tissue,which may be important molecular biological signals in the genesis of cervical squamous carcinoma. Twist and Snail may promote the progression of cervical squamous epithelial lesions through mediating EMT, and lead to cervical squamous carcinoma eventually.更多还原