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目的:探讨E-cadherin、Twist表达与子宫颈癌局部浸润及临床病理参数之间的关系。方法:应用组织芯片技术和免疫组织化学方法检测宫颈浸润癌34例、微小浸润癌30例、子宫颈上皮内瘤变(cervical intr-aepithelial neoplasias,CIN)Ⅲ30例、子宫颈慢性炎症30例E-cadherin、Twist的表达,并与临床病理资料进行分析。结果:E-cadherin在子宫颈慢性炎症、CINⅢ、微小浸润癌、浸润癌中的阳性表达率分别为87%(26/30)、60%(18/30)、40%(12/30)、18%(6/34),其阳性表达率随病变级别升高而明显减少;而且浸润癌中Ecadherin在高分化组及TNMⅢ、Ⅳ期组明显高于中低分化组和Ⅰ、Ⅱ期组(P<0.05),与肿瘤体积、淋巴结转移无关(P>0.05);Twist在子宫颈慢性炎症、CINⅢ、微小浸润癌、浸润癌中的阳性表达率分别为30%(9/30)、40%(12/30)、70%(21/30)、79%(27/34)其阳性表达随病变级别增加而上升;Twist表达水平在肿瘤直径>2cm组及中低分化组明显高于≤2cm和高分化组(P<0.05),有无淋巴结转移组和不同TNM分期组间差别无统计学意义无关(P>0.05);E-cadherin、Twist表达水平在子宫颈慢性炎症和浸润癌中两者的表达无相关性(P>0.05),在CINⅢ以及微小浸润癌中表达存在明显负相关(r=-0.6693,P<0.05和r=-0.7946,P<0.05)。结论:Twist和E-cadherin参与子宫颈上皮内病变进展和局部浸润癌的发展,Twist表达升高和E-cadherin表达缺失是子宫颈癌恶性进展的重要指标。
Objective: To investigate the relationship between E-cadherin, Twist expression and local invasion and clinicopathologic parameters of cervical cancer. Methods: Tissue microarray and immunohistochemistry were used to detect 34 cases of invasive cervical carcinoma, 30 cases of microinvasive carcinoma, 30 cases of cervical intr-aepithelial neoplasias (CIN) Ⅲ, 30 cases of chronic cervicitis, cadherin, Twist expression, and clinical and pathological data analysis. Results: The positive expression rates of E-cadherin in chronic cervicitis, CINⅢ, micro-invasive carcinoma and invasive carcinoma were 87% (26/30), 60% (18/30), 40% (12/30) 18% (6/34). The positive expression rate of Ecadherin in well-differentiated and TNMⅢ-Ⅳgroups was significantly higher than that in moderate-poorly differentiated andⅠandⅡstage groups (P <0.05), but no correlation with tumor volume and lymph node metastasis (P> 0.05). The positive rates of Twist in chronic cervicitis, CIN Ⅲ, microinvasive carcinoma and invasive carcinoma were 30% (12/30), 70% (21/30), 79% (27/34). The positive expression of Twist increased with the increase of the lesion level. The expression level of Twist was significantly higher than that of ≤2cm (P <0.05). There was no significant difference between lymph node metastasis group and TNM staging group (P> 0.05). The expression of E-cadherin and Twist in chronic cervicitis and invasive carcinoma (P> 0.05). There was a significant negative correlation between the expression of CIN Ⅲ and microinvasive carcinoma (r = -0.6693, P <0.05 and r = -0.7946, P <0.05). Conclusion: Twist and E-cadherin are involved in the progression of cervical intraepithelial neoplasia and the development of locally invasive carcinoma. The increase of Twist expression and the loss of E-cadherin expression are important indicators of malignant progression of cervical cancer.