【作者】 聂艳婷；

【导师】 刘凤英；

【作者基本信息】 中南大学 ， 妇产科学， 2010， 硕士

【摘要】 目的：检测宫颈鳞癌及癌前病变患者病理组织中β-catenin、DKK-1的表达,探讨其与宫颈鳞癌发生发展、临床病理各参数之间的关系。方法：1.收集在我院经临床和病理确诊宫颈鳞癌组44例、CIN组30例、慢性宫颈炎组30例病理组织标本,采用免疫组化SABC法检测β-catenin、DKK-1的表达。2.分析β-catenin、DKK-1的表达与宫颈鳞癌发生、发展及患者年龄,临床分期,组织学分级,肌层浸润程度、淋巴结转移、高危型HPV感染的关系,并分析β-catenin、DKK-1表达的相关性。结果：1.β-catenin在慢性宫颈炎组织中均为细胞膜着色；在CIN及宫颈癌组织中表现为膜表达减弱或缺失,呈现异位表达(胞质或胞核着色)；其在慢性宫颈炎、CINⅠ、CINⅡ-Ⅲ、宫颈鳞癌中异常表达率分别为0,15.4%,52.9%,79.5%,四组比较差异有显著性(P＜0.05)。2.DKK-1阳性表达定位于胞浆中,在慢性宫颈炎、CINⅠCINⅡ-Ⅲ、宫颈鳞癌中阳性表达率依次降低,其阳性表达率分别为：83.3%,76.9%,35.3%,11.4%,四组比较差异有显著性(P＜0.05)。3.β-catenin在各病理分级中的异常表达率随组织学分级的升高而上升,其阳性表达率分别为：G1-G2：66.7%,G3：91.3%,差异有显著性(P＜0.05)；在高危型HPV感染阳性组及阴性组的异常表达率分别为：83.3%,0,差异有显著性(P<0.05)。DKK-1的阳性表达率随着组织学分级的升高而降低,其阳性表达率分别为：G1-G2：23.8%,G3：0,差异有显著性(P<0.05)；在高危型HPV感染阳性组及阴性组的阳性表达率分别为：7.1%,100.0%,差异有显著性(P＜0.051。4.β-catenin在FIGO分期中Ⅰbl-Ⅰb、Ⅱ2a期的异常表达率分别为76.0%,84.2%,差异无显著性(P>0.05)；在浅、深肌层浸润组的异常表达率分别为75.0%,82.1%,差异无显著性(P>0.05)；<40岁组和≥40岁组的异常表达率分别为77.3%,81.8%,差异无显著性(P>0.05)；有淋巴结转移组及无淋巴结转移组的异常表达率分别为90.0%,76.5%,差异无显著性(P>0.05)。5.DKK-1在Ⅰb1-Ⅰb2、Ⅱa期的阳性表达率分别为16.0%,5.3%,差异无显著性(P>0.05)；在浅、深肌层浸润组的阳性表达率分别为18.8%,7.1%,差异无显著性(P>0.05)；<40岁组和≥40岁组的阳性表达率分别为13.6%,11.1%,差异亦无显著性(P>0.05)；在有淋巴结转移组及无淋巴结转移组的阳性表达率分别为10.0%，11.8%,差异无显著性(P>0.05)。6.宫颈癌中β-catenin和DKK-1的表达存在负相关,相关系数为r=-0.706,P=0.000。结论：1.在宫颈鳞状上皮恶性转化的过程中,随着病变程度的增加,β-catenin的异常表达率逐渐增高,DKK-1阳性表达率逐渐降低,提示β-catenin、DKK-1可能在宫颈鳞癌的发生过程中起一定作用。2.β-catenin、DKK-1的表达与宫颈鳞癌组织病理分级有关,提示β-catenin、DKK-1表达水平可能在一定程度上反映了宫颈鳞癌的恶性程度；两者的表达与高危型HPV感染有关,提示两者的异常表达可能协同高危型HPV在宫颈鳞癌的发生过程中起作用。3.宫颈癌中β-catenin和DKK-1的表达存在负相关,提示DKK-1的表达缺失可能促进了β-catenin异常表达。更多还原

【Abstract】 OBJECTIVETo detect the expression of P-catenin and DKK-1 in chronic cervicitis, CIN,cervical squamous carcinoma,to explore the relationship between the expression of P-catenin or DKK-1 and the genesis,clinic pathological parameters of cervical squamous carcinoma and to explore the function of P-catenin and DKK-1 in the genesis and development of cervical squamous carcinoma.METHODS1.There are 30 patients with chronic cervicitis,30patients with CIN, and 44 patients with FIGO stageⅠb1 toⅡa.The expression of P-catenin and DKK-1 were deteced by immunohistochemistry technique.2.Analysing the relationship between the expression ofβ-catenin or DKK-1 and the age of patients,surgical stage,myometrial invasion,patho-logical grading or lymphatic metastasis; exploring the function ofβ-catenin and DKK-1 in the genesis and development of cervical squamous carcinoma; analysing the correlation betwwen the expression ofβ-catenin and DKK-1.RESULTS1.β-catenin showed nomal expression in 30 chronic cervicitic tissues,and showed abnomal expression(cytoplasic expression) in the tissues of cervical intraepithelial neoplasia and cervical squamous carcinoma. The abnomal expression rates ofβ-catenin in the chronic cervical tissues, CINⅠ,CINⅡ-Ⅲand cervical squmaous careinoma were respectively 0,15.4%,52.9%,79.5%. There was signifieantly dieffrence respectively(P＜0.05). 2.DKK-1 expressed in cytoplasic. The positive expression rates of DKK-1 in the chronic cervical tissues, CINⅠ,CINⅡ-Ⅲand cervical squmaous careinoma were respectively 83.3%,76.9%,35.3%,11.4%. There was signifieantly dieffrence respectively(P<0.05).3. The abnomal expression rate ofβ-catenin and the positive expression rate of DKK-1 were significantly associated with the tumor diefferntiation stuats and high-risk human papillomavirus infection (P<0.05).4.The abnomal expression rate of P-catenin in FIGO stageⅠb1-Ⅰb2 andⅡa were respectively 76.0%,84.2%.There was no signifieantly dieffrence(P<0.05). The abnomal expression rate of P-catenin were not associated with myometrial invasion, the age of patients, pelvic lymph node metastases. (P<0.05)5.The positive expression rate of DKK-1 in FIGO stageⅠb1-Ⅰb2 andⅡa were respectively 16.0%,5.3%.There was also no signifieantly dieffrence (P＜0.05). The positive expression rate of DKK-1 were not associated with myometrial invasion, the age of patients, pelvic lymph node metastases. (P＜0.05)6.There is significant negative correlation between the expression ofβ-catenin and DKK-1.(r=-0.706, P=0.000)Conclusion1.In cervieal squarnous cell malignant transformation process, with the lesions inerease,the abnomal expression rate ofβ-catenin increased, and the positive expression rate of DKK-1 decrese. They may play an important role in carcinogenesis.2. The abnomal expression rate ofβ-catenin and the positive expression rate of DKK-1 were significantly associated with the tumor diefferntiation stuats and high-risk human papillomavirus infection. They may reflect the malignant degree of cervical tissues, and play an important role in carcinogenesis collaborating with high-risk human papillomavirus infection.3. There is significant negative correlation between the expression ofβ-catenin and DKK-1.(r=-0.706, P=0.000) The loss of DKK-1 may promote the abnomal expression of P-catenin, so as to lead to the occurrence and development of cervical cancer.更多还原