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目的探讨宫颈鳞癌组织中X染色体连锁凋亡抑制蛋白(XIAP)的表达水平与新辅助化疗耐药是否相关。方法收集78例宫颈鳞癌患者的癌组织及40例正常宫颈及慢性宫颈炎组织,其中32例宫颈癌患者术前进行了新辅助化疗2个疗程,同时也收集2个疗程后的癌组织。根据疗效将32例患者分为化疗敏感组和耐药组。通过免疫组化SP法检测XIAP在宫颈癌组织、癌旁组织和新辅助化疗后的癌组织中的表达情况。结果相对于癌旁组织或正常组织中的低表达或几乎不表达,XIAP在癌组织中高表达,XIAP在癌组织中的表达与有无淋巴结转移和组织分化程度方面差异有统计学意义(P<0.05),在临床分期及年龄方面差异无统计学意义(P>0.05)。化疗敏感组中XIAP的表达积分化疗后较化疗前显著降低(P<0.01),而在化疗耐药组中差异无统计学意义(P>0.05)。化疗前两组患者的XIAP表达积分差异无统计学意义(P>0.05)。结论 XIAP在子宫颈癌组织中表达水平明显升高,可能与宫颈癌复发及转移有关。同时XIAP表达水平的变化与新辅助化疗是否耐药密切相关,可能为开发新的化疗药物提供靶位点。
Objective To investigate whether the expression of X-linked inhibitor of apoptosis protein (XIAP) in cervical squamous cell carcinoma is related to the resistance of neoadjuvant chemotherapy. Methods Tumors were collected from 78 cases of cervical squamous cell carcinoma and 40 cases of normal cervix and chronic cervicitis. 32 patients with cervical cancer underwent two courses of neoadjuvant chemotherapy before surgery and two courses of cancer after surgery. According to the efficacy of 32 patients were divided into chemotherapy-sensitive group and resistant group. Immunohistochemical SP method was used to detect the expression of XIAP in cervical cancer tissue, adjacent tissue and neoadjuvant chemotherapy. Results The expression of XIAP was significantly higher in cancerous tissues than that in para-cancerous tissues or normal tissues. There was a significant difference in the expression of XIAP in cancerous tissues with or without lymph node metastasis and histological differentiation (P < 0.05). There was no significant difference in clinical stage and age (P> 0.05). The expression of XIAP in chemosensitive group was significantly lower after chemotherapy than before chemotherapy (P <0.01), while there was no significant difference in chemotherapy-resistant group (P> 0.05). There was no significant difference in XIAP expression scores between the two groups before chemotherapy (P> 0.05). Conclusion The expression of XIAP in cervical cancer tissues was significantly increased, which may be related to the recurrence and metastasis of cervical cancer. At the same time, the change of XIAP expression level is closely related to the resistance of neoadjuvant chemotherapy and may provide a target site for the development of new chemotherapy drugs.