转录因子扭曲基因表达异常在早期子宫颈癌发病中的意义及对预后的影响

摘要

Objective To investigate the significance of abnormal expression of twisted gene transcription factor ( Twist) in pathogenesis of early-stage cervical cancer and its influence on prognosis.Methods Totally 87 cases of early-stage cervical cancer, 43 cases of cervical intraepithelial neoplasia ( CIN) and 40 cases of normal uterine tissues were selected.The expressions of Twist gene in early-stage cervical cancer, CIN and normal tissues were detected by using real-time PCR.All patients with early-stage cervical cancer were postoperatively followed up till May 31, 2015.Taking the median of Twist mRNA expression level in early-stage cervical cancer tissues as cutoff value, the patients were divided into high expression group ( n=46 ) and low expression group ( n=41 ) .The progression-free survival time and survival time were analyzed by using Kaplan-Meier survival analysis.Results The relative expression levels in early-stage cervical cancer tissues was 2.21 ±0.17, which was higher than that in CINⅡand CINⅢtissues(1.32 ±0.13, 1.71 ±0.15) and that in normal uterine tissue (1.06 ±0.11).And it was higher in CINⅢthan in CINⅡand than in normal uterine tissue with statistically significant differences (P<0.05).The relative expression levels of Twist mRNA in early-stage cervical cancer tissues were related with clinical stage, degree of differentiation, histological type and lymph node metastasis ( t value was 27.721, 18.047, 18.213 and 19.483, respectively, all P<0.05).The median progression-free survival time in low expression group was 49.43 months, and in high expression group it was 37.52 months.Log Rank test showed significant difference (χ2 =4.350, P=0.037).The median survival time in low expression group was 53.83 months, and in high expression group it was 43.91 months.Log Rank test showed significant difference (χ2 =4.381, P=0.036). Conclusion Twist gene is highly expressed in early-stage cervical cancer tissue.The progression-free survival time and survival time of high expression patients after surgery are shortened.%目的：探讨转录因子扭曲基因（ Twist）表达异常在早期子宫颈癌发病中的意义及对预后的影响。方法选取早期子宫颈癌患者87例，子宫颈上皮内瘤变（ CIN）患者43例和正常子宫组织40例，实时荧光定量PCR检测早期子宫颈癌、CIN和正常子宫组织中Twist基因表达，早期子宫颈癌患者术后随访截止2015年5月31日，以早期子宫颈癌组织中Twist mRNA表达量中位值为界值，将患者分为高表达组（n＝46）和低表达祖（n＝41），利用Kaplan-Meier生存分析法分析无进展生存时间和生存时间。结果早期子宫颈癌组织中Twist mRNA相对表达量（2．21±0．17），高于CINⅡ和CINⅢ组织中的（1．32±0．13）和（1．71±0．15）及正常子宫组织中的（1．06±0．11），且CINⅢ＞CINⅡ＞正常子宫组织，差异均有统计学意义（P＜0．05）；早期子宫颈癌组织中Twist mRNA相对表达量与临床分期、分化程度、病理类型和淋巴结转移有关（t值分别为27．721、18．047、18．213、19．483，均P＜0．05）；低表达组患者中位无进展生存时间49．43个月，高表达组患者中位无进展生存时间37．52个月，Log Rank检验显示差异有统计学意义（χ2＝4．350，P＝0．037），低表达组患者中位生存时间53．8个3月，高表达组患者中位生存时间43．91个月，Log Rank检验显示差异有统计学意义（χ2＝4．381，P＝0．036）。结论 Twist基因在早期子宫颈癌组织中呈高表达，高表达患者术后无进展生存时间和生存时间缩短。