青島市嶗山區(qū)農(nóng)村婦女宮頸癌普查及Id1蛋白檢測分析.pdf

1、青島市嶗山區(qū)農(nóng)村婦女宮頸癌普查及Id1蛋白檢測分析摘要背景宮頸癌是女性生殖器宮三大惡性腫瘤之一，位居第二位，已成為嚴重威脅婦女健康的常見疾病，近年來宮頸癌及癌前病變的發(fā)病率呈現(xiàn)上升和年輕化趨勢。由于宮頸癌早期沒有特異性臨床癥狀，發(fā)現(xiàn)時多數(shù)已為晚期，防治的關(guān)鍵是通過篩查發(fā)現(xiàn)癌前病變。如何及早發(fā)現(xiàn)宮頸癌前病變或早期癌癥，已被公認為是宮頸癌防治中最能有效地提高患者生存率和降低死亡率的措施，因此尋找宮頸癌的早期診斷和判斷其預(yù)后的腫瘤標記物尤為迫

2、切。Idl(InhibitorofDNAbindingorinhibitorofdifferentiation)是雙螺旋環(huán)轉(zhuǎn)錄因子家族成員之一，通過調(diào)控基因表達，對細胞分化起負性調(diào)節(jié)作用，能抑制細胞分化，促進細胞增生。近年研究表明，Idl蛋白在多種惡性腫瘤包括宮頸癌組織中高表達，而且表達的高低與癌組織的惡性程度、預(yù)后有一定的關(guān)系。目的對嶗山區(qū)8000名年齡3559歲農(nóng)村婦女進行宮頸癌篩查，先采用宮頸細胞學檢查，對高危者進行活檢取宮頸組織

3、進行HE染色，統(tǒng)計病變率；并進一步對上皮瘤內(nèi)病變者(CIN)和癌變者進行Idl蛋白表達檢測，分析其與病變的相關(guān)性，以期從蛋白水平揭示Idl與宮頸病變之間的關(guān)系，有助于了解Idl在上皮性宮頸腫瘤的診斷中的臨床應(yīng)用的價值，探討Idl作為新瘤標臨床應(yīng)用的可能性。方法對8000例嶗山區(qū)轄區(qū)內(nèi)3559歲農(nóng)村戶籍婦女行宮頸癌檢查。宮頸癌檢查項目采用宮頸液基細胞學檢查(LCT方法)，將LCT異?；颊叻諥SCUS(意義不明的非典型鱗狀上皮)，CINI—

4、II(LSIL低度鱗狀上皮內(nèi)病變)，CINII—III(HSIL高度鱗狀上皮內(nèi)病變)。對上述患者分類檢查：ASC—US行復(fù)查LCT和(或)HPV檢查，復(fù)查異常者行宮頸活組織檢查，取樣后送病理，判斷分為CINI—III和宮頸浸潤癌。對活檢異?；颊甙℉PV異常及CINI以上患者活檢制成石蠟切片，先進行HE染色確定CINI、II、III期和癌變組織，然后對上述組織進行免疫組化染色檢測Idl蛋白在上述宮頸組織中的表達，然后用JD801圖像分析

5、系統(tǒng)進行圖像分析，計算陽性細胞百分比和灰度值的平均值，并進一步分析Idl表達與CIN分期的相關(guān)性。結(jié)果嶗山區(qū)8000名受檢者中LCT異常者共121例，其中ASCUS9例，ASCH5例，LSIL57例，HSIL45例，AGC(非典型腺細胞)4例，AC(腺癌)1例。121例患者進行陰道鏡下宮頸活檢術(shù)，活檢結(jié)果異常共62例，其中CINI17例，CINII14例，ScreeningofcervicalcancerinruralwomenofQi

6、ngdaoLaoshanDistrictandthedetectionofldlproteinAbstractBackground：CervicalcancerisoneofthethreemalignanttumorsinfemalereproductiveorgansandrankedsecondIthasbecomea。commonandseriousdiseasethatthreatstowomen’ShealthInrecen

7、tyears，theincidenceofcervicalcancerandprecancerouslesionhasincreasedandbecometheyoungtendencyAsaresultofearlycervicalcancerhasnospecificclinicalsymptoms，themajorityfoundalreadybelongstothelatecancerScreeningtodetectpreca

8、ncerouslesionsisthekeyofpreventionIthasbeenrecognizedthathowtofindcervicalprecancerouslesionsandearlycancersisthemosteffectivemeaslestoincreasesurvivalrateanddecreasethemortalityrateincervicalcancerAtpresent，lookingfortu

9、mormarkersisalwaystheresearchhotspotforearlydiagnosisandprognosisIdl(InhibitorofDNAbindingorinhibitorofdifferentiation)belongstothefamilyoftranscriptionfactorwithdoublehelixringstructure(helixloo甜1elix，HLH)ItCannegativer

10、egulatethecelldifferentiationbyregulationthegeneexpression，SObecomethefactortoinhibitthecelldifferentiationRecentstudiesshowedthat，IdlWasoverexpressioninavarietyofmalignanttumorsincludingcervicalcancer111eoverexpressionl

11、evelandcancerprognosisormalignantdegreehasacertainrelationshipincervicalcancerobjeetive：CervicaldiseasescreeningWasperformedin8000ruralwomenaged35—59yearsinQingdaoLaoshanDistrictTheliquidbasedcytologytest(LCT)wasusedfirs

12、tlyCervicalbiopsyandHEdyingWasthenusedinhighriskpatientsTherateofcervicaldiseasesWascalculatedandstatasisedTheexpressionofIdlproteinWasfurtherdetected，andtherelationship謝thcervicallesionsWasanalysisedItWasexpectedtofurth

13、erfendthecorrelationbetweenIdlandcervicallesions，toknowthediagnosisvalueofIdlinepithelialtumorsinclinicalapplicationandtoexplorethepossibilityofldlasanewtumormarkerMethods：CervicaldiseasescreeningWasperformedin8000ruralw

14、omenaged3559yearsinQingdaoLaoshanDistrictTheliquidbasedcytologytest(LCT)WasusedfirstlythentheabnormalsampleswimLCTweredividedintoASCUSCINIII(LSIL)，CINIIIII(HSIL)ThecaseswerefurtherdetectedforHPVDNABiopsyundercolposcopeWa