年轻宫颈鳞癌组织中微血管形成及c－Myc和CO X－2表达的临床病理研究

摘要

目的：研究原癌基因（c－Myc）和环加氧酶2（COX－2）在宫颈上皮内瘤样病变（CIN）和宫颈鳞癌（SCC）中的表达及与微血管密度（MVD）的相关性，探讨c－Myc和COX－2在SCC 发生、发展中的相互关系及其表达与临床病理联系。方法选择2007年1月至2011年12月邯郸市妇幼保健院和邯郸市中医院手术切除的SCC组织标本40份、CIN标本31份，正常宫颈组织（ NCE）10份，采用免疫组织化学SP法检测各组c－Myc和COX－2的表达情况和微血管密度（ MVD）（ CD34标记）。分析两者在SCC组中的阳性表达情况及与肿瘤分期早晚、病理分型高低、淋巴结转移等病理指标之间的相互关系。结果 c－Myc在SCC组中的阴性表达率为62．5％（25／40），显著高于 CIN组和 NCE 组（ P ＜0．01），在SCC组中c－Myc的表达与分化及淋巴结转移有关（P＜0．01）。在SCC组中，COX－2阳性表达率为67．5％（27／40），显著高于CIN组和NCE组（P＜0．01），COX－2的表达与 SCC 的临床病理分期及淋巴结转移有关（P＜0．01）。相关性分析表明两者在SCC组织中的表达呈正相关，并且两者在宫颈癌血管生成中可能具有协同作用。结论 c－Myc 和 COX－2在年轻 SCC 发生、发展中起重要作用，c－Myc和COX－2上调表达可作为SCC预后的判断指标。%Objective To investigate the expression of COX-2 and c-Myc in cervical intraepithelial neo-plasia(CIN) and squamous cell carcinoma(SCC) of young women under 35,and their correlation with microvessel density( MVD) ,so as to explore the correlation of COX-2 and c-Myc with the incidence and pro-gression of SCC,as well as the correlation of their expression with clinical pathology .Methods Cervical tis-sue samples of 40 young patients with SCC,samples of 31 young patients with CIN and samples of 10 young patients with normal cervical tissues admitted in Handan Maternal and Child Health Care Hospital and Han-dan Hospital of Traditional Chinese Medicine were selected as research objects,the expressions of COX-2, c-Myc and microvessel density(MVD) labeled by CD43 of all the samples were detected by immunohisto-chemistry S-P method,and the positive expression status of COX-2 and c-Myc in SCC tissues,as well as their relationship with neoplasm staging,pathological type,and lymph node metastasis were analyzed.Results The positive expression rate of c-Myc in SCC was 62.5%(25/40),which was significantly higher than that in CIN and normal cervical tissues(P<0.01),the expression of c-Myc was correlated with myometrial inva-sion and lymph node metastasis(P<0.01).The expression rate of COX-2 in SCC was 67.5%(27/40), which was significantly higher than that in CIN and normal cervical tissues (P <0.01),the expression of COX-2 was correlated with the pathological stage of SCC and lymph node metastasis (P<0.01).It turned out that the expression of COX-2 and c-Myc were positively correlated in SCC ,and such expression had syn-ergistic effect on the formation of microvessels in cervical carcinoma .Conclusion COX-2 and c-Myc play important roles in the incidence and progression of SCC ,the high expression of COX-2 and c-Myc can be the indicator for the prognosis of SCC.