【作者】 黄江生；

【导师】 李敏；

【作者基本信息】 兰州大学 ， 病理学与病理生理学， 2007， 硕士

【摘要】 目的：通过组织学观察EphA2、EphrinA1和E-cadherin在宫颈鳞癌组织中的表达情况及其与宫颈鳞癌临床病理指标之间的关系，并与CD31标记的微血管密度之间作比较，为肿瘤早期诊断和抗血管治疗提供新的思路和作用靶点。方法：应用免疫组织化学二步法检测38例宫颈鳞癌组织及20例正常宫颈上皮组织中EphA2、EphrinA1和E-cadherin的表达。结果：1．20例正常宫颈上皮中，EphA2阴性表达16例(80.0％)，弱阳性表达4例(20.0％)；EphrinA1阴性表达14例(70.0％)，弱阳性表达5例(25.0％)，阳性表达1例(5.0％)。2．EphA2和EphrinA1阳性染色定位于癌细胞、淋巴细胞和血管内皮细胞的胞浆，呈棕黄色，染色均一。38例宫颈鳞癌中，EphA2表达阴性表达7例(18.4％)，弱阳性表达16例(42.1％)，阳性表达10例(26.3％)，强阳性表达5例(13.2％)；几乎所有组织的血管内皮细胞均呈EphA2阳性表达，且染色强度一致。EphA2在宫颈鳞癌中的表达明显高于正常宫颈(P＜0.001)；EphrinA1阴性表达8例(21.1％)，弱阳性表达17例(44.6％)，阳性表达8例(21.1％)，强阳性表达5例(13.2％)，EphrinA1也在几乎所有的肿瘤组织的血管内皮细胞表达，且染色强度一致，EphdnA1在宫颈鳞癌中的表达均明显高于正常宫颈组织(P＜0.01)。3．EphA2和EphdnA1蛋白表达与宫颈鳞癌患者的年龄、FIGO分期以及淋巴结转移均无统计学相关性，而与肿瘤的组织学分级有关。4．EphA2和EphrinA1阳性染色共同定位于相同的肿瘤区域和血管内皮细胞，二者在宫颈鳞癌组织中的表达分布基本一致，经统计学分析，二者的阳性表达呈正相关(r=0.587，P＜0.01)。5．在正常宫颈上皮中E-cadhenrin表达于细胞膜，鳞癌中膜表达减弱甚至无表达。E-cadherin在正常宫颈阳性表达率与鳞癌比较，有显著性差异(P＜0.05)。6．E-cadherin表达与宫颈鳞癌患者的年龄无关(P＞0.05)，与FIGO分期、淋巴结转移、临床分期和组织学分级有关，P＜0.05)。7．宫颈鳞癌中EphA2和EphrinA阳性表达与CD31标记的MVD值之间无相关性(r_s=-0.152，r_s=-0.158，P＞0.05)。结论：1．EphA2和EphfinA1蛋白在宫颈鳞癌中高表达，提示二者可能与宫颈癌的癌变有关。2．EphA2和EphrinA1蛋白表达与宫颈鳞癌的组织学分级有关，而与FIGO分期以及淋巴结转移无关，提示二者可能与宫颈鳞癌的发生、发展有关，而与转移无关。3．E-cadherin在宫颈鳞癌中膜表达减弱至无表达，与肿瘤失分化、浸润性生长、转移及不良预后明显相关。4．EphA2和EphrinA阳性表达与CD31标记的MVD值之间无相关性。更多还原

【Abstract】 Objective By the histological observation of EphA2、EphrinA1 and E-cadherin express in squamous cervical carcinomas, to discuss the relationship to clinicopathological parameters, moreove compared with MVD which stained by CD31 antibody, in order to provide a new ideal and effective target for early diagnosis and antivascular therapy for tumor.Methods The expression of EphA2 /EphrinA1 and E-cadherin in 38 squamous cervical carcinomas and 20 normal cervical tissues were studied by immunohistochemistry, and their relationships to clinicopathological characteristics were analyzed.Results1 The expression rate of EphA2 was negative of 16(80.0%), and weakly positive of 4(20. 0%);The expression of EphrinA1 was negative of 14(70.0%), weakly positive of 5(25.0%), and positive of 1(5. 0%), in 20 cases of normal cervical tissues..2 The expression area of EphA2 and EphrinA1 locating to the endochylema of the cancer cells ,lymph cells and vascular endothelial cells(VEC), to offer buffy and uniform..In 38 cases of the squamous carcinoma of the cervix,the expression of EphA2 was negative of 7(18.4%), weakly positive of 16(42.1%), and positive of 10(26.3%), powerful positive of 5(13.2%); almost the overall of VEC expressed the unity intensity of EphA2.The expression rate of EphA2 in squamous cervical carcinoma was significantly higher than which expressed in normal cervicaltissues(P<0.001); the expression of EphrinA1 was negative of 8(21.1%), weakly positive of 17(44.6%), and positive of 8(21.1%), powerful positive of 5(13.2%); almost the overall of VEC expressed the unity intensity of EphrinA1. Its expression rate in squamous cervical carcinoma was significantly higher than which expressed in normal cervical tissues(P<0. 001).3 The expression of EphA2 and EphrinA1 protein has no statistics dependablity with age, staging of FIGO, lymphatic metastasis in squamous cervical carcinomas. 4 EphA2 and EphrinA1 positive staining localized identical carcinoma area and vascular endothelial cells, and distributed consonance in cervical carcinoma.positive expression offered positive correlation(r=0. 587, P<0. 01).5 It was significant difference about E-cadherin expression between normal cervix tissues and cervical carcinoma, expression of E-cadherin was weaken or no expression in squamous carcinoma of the cervix and expressed about cellularmembrane in normal cervix epithelium cells(P<0.05).6 Expression of E-cadherin has correlation with staging of FIGO, lymphatic metastasis, clinical stage, histological graded and no correlation with age (P< 0.05).7 It was no correlation with positive expression of EphA2, EphrinA1 and MVD numerical value labeled by CD31 in cervical carcinoma, (r_s=-0.152, r_s=-0.158, P>0.05).Conclusions:1 It was correlation with cervical carcinoma about high positive expression of EphA2 and EphrinA1 protein in squamous carcinoma of the cervix.2 It has no correlation with staging of FIGO and lymphatic metastasis aboutexpression EphA2 and EphrinA1 protein in cervical carcinoma, but havecorrelation between histologic stage of squamous carcinoma of the cervix . Indicated they have nothing to do with metastasis in squamous carcinoma of the cervix, but have correlation with development and progression.3 Expression of E-cadherin was weaken or no expression in squamous carcinoma of the cervix, and strongger correlation with carcinoma differentiation, infiltrative growth, metastasis and prognosis.4 It was no correlation to positive expression of EphA2, EphrinA1 and MVD numerical value labeled by CD31.更多还原