青島市嶗山區(qū)農(nóng)村婦女宮頸癌普查及Id1蛋白檢測(cè)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(cè)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(yán)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(shì)。由于宮頸癌早期沒有特異性臨床癥狀，發(fā)現(xiàn)時(shí)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(rèn)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(biāo)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(dá)，對(duì)細(xì)胞分化起負(fù)性調(diào)節(jié)作用，能抑制細(xì)胞分化，促進(jìn)細(xì)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(dá)，而且表達(dá)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(duì)嶗山區(qū)8000名年齡3559歲農(nóng)村婦女進(jìn)行宮頸癌篩查，先采用宮頸細(xì)胞學(xué)檢查，對(duì)高危者進(jìn)行活檢取宮頸組織

3、進(jìn)行HE染色，統(tǒng)計(jì)病變率；并進(jìn)一步對(duì)上皮瘤內(nèi)病變者(CIN)和癌變者進(jìn)行Idl蛋白表達(dá)檢測(cè)，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(jià)值，探討Idl作為新瘤標(biāo)臨床應(yīng)用的可能性。方法對(duì)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(xiàng)目采用宮頸液基細(xì)胞學(xué)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(duì)上述患者分類檢查：ASC—US行復(fù)查L(zhǎng)CT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(rùn)癌。對(duì)活檢異?；颊甙℉PV異常及CINI以上患者活檢制成石蠟切片，先進(jìn)行HE染色確定CINI、II、III期和癌變組織，然后對(duì)上述組織進(jìn)行免疫組化染色檢測(cè)Idl蛋白在上述宮頸組織中的表達(dá)，然后用JD801圖像分析

5、系統(tǒng)進(jìn)行圖像分析，計(jì)算陽(yáng)性細(xì)胞百分比和灰度值的平均值，并進(jìn)一步分析Idl表達(dá)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(xì)胞)4例，AC(腺癌)1例。121例患者進(jìn)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