Yes相关蛋白、AEG-1蛋白在宫颈癌癌前病变患者中表达及联合液基细胞学检查的临床意义
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摘要
目的探讨Yes相关蛋白(Yes-associated protein,YAP)、星型胶质细胞上调基因-1(astrocyte elevated gene-1,AEG-1)蛋白在宫颈癌癌前病变患者中的表达及联合液基细胞学检查(liquid-based cytology test,LCT)的临床意义。方法选取2015年5月至2017年5月于邢台市康复医院行宫颈癌筛查和住院治疗的妇科疾病患者共126例,所有患者均经阴道镜检查并行病理活检,依据病理结果依次分为对照组(正常或宫颈炎症,51例)、宫颈上皮内瘤变(cervical intraepithelial neoplasias,CIN)Ⅰ组(30例)、CINⅡ组(25例)、CINⅢ组(20例)。检测不同病变患者YAP、AEG-1蛋白的表达情况同时行LCT检测,比较不同病症患者间临床指标的差异,采用ROC曲线比较YAP、AEG-1蛋白联合LCT检测诊断宫颈癌癌前病变的诊断效能。结果对照组、CINⅠ组、CINⅡ组、CINⅢ组YAP阳性表达率分别为11.8%、36.7%、52.0%、75.0%,差异有统计学意义(χ~2=29.085,P<0.01);对照组、CINⅠ组、CINⅡ组、CINⅢ组AEG-1蛋白阳性表达率分别为为3.9%、26.7%、80.0%、95.0%,差异有统计学意义(χ~2=72.400,P<0.01);经LCT检测,无宫颈上皮瘤变73例,非典型鳞状上皮细胞9例,低度鳞状上皮内瘤变15例,高度鳞状上皮内瘤变29例,鳞状细胞癌0例,阳性预测值为96.2%;YAP、AEG-1蛋白联合LCT检测诊断宫颈癌前病变灵敏度、阴性预测值及ROC曲线下面积明显高于各指标单独诊断(P<0.05)。结论 YAP、AEG-1蛋白检测在子宫颈癌癌前病变的筛查中具有指导意义。随着宫颈病变的程度加重,YAP、AEG-1蛋白表达率逐渐增加。YAP、AEG-1蛋白联合LCT检测,有助于提高临床诊断灵敏度。
Objective To investigate the expression of Yes-associated protein(YAP) and astrocyte elevated gene-1(AEG-1) protein in cervical cancer precancerous lesions and their combined liquid-based cells The clinical significance of the liquid-based cytology test(LCT).Methods A total of 126 patients with gynecological diseases who underwent cervical cancer screening and hospitalization in Xingtai City Rehabilitation Hospital from May 2015 to May 2017 were selected. All patients underwent colposcopy and pathological biopsy and were divided into normal group(normal or cervical inflammation group, 51 cases), CINI group(30 cases), CINII group(25 cases), CINIII group(20 cases). To detect the expression of YAP and AEG-1 protein in patients with different diseases and to compare the clinical indexes of patients with different diseases. To compare the diagnostic efficacy of YAP, AEG-1 protein combined with LCT in the diagnosis of cervical cancer precancerous lesions by ROC curve. Results The positive expression rates of YAP in the control group, CINI group, CINII group and CINIII group were 11.8 %, 36.7 %, 52.0 %, and 75.0 %, respectively. The differences were statistically significant(χ~2=29.085, P<0.01). The control group, CINI group, The positive expression rates of AEG-1 protein in CINII group and CINIII group were 3.9 %, 26.7 %, 80.0 %, and 95.0 %, respectively, and the differences were statistically significant(χ~2=72.400, P<0.01). According to LCT, there were 73 cases of cervical epithelial tumor, 9 cases of atypical squamous epithelial cells, 15 cases of low grade squamous intraepithelial neoplasia, 29 cases of highly squamous intraepithelial neoplasia, and 0 cases of squamous cell carcinoma. The predicted value was 96.2 %; the sensitivity, negative predictive value and area under the ROC curve of YAP, AEG-1 protein combined with LCT were significantly higher than those of each index(P<0.05). Conclusion YAP and AEG-1 protein detection have guiding significance in the screening of cervical cancer precancerous lesions. As the degree of cervical lesions worsened, the expression rates of YAP and AEG-1 proteins gradually increased. YAP, AEG-1 protein combined with LCT detection can help to improve the sensitivity of clinical diagnosis.
Objective To investigate the expression of Yes-associated protein(YAP) and astrocyte elevated gene-1(AEG-1) protein in cervical cancer precancerous lesions and their combined liquid-based cells The clinical significance of the liquid-based cytology test(LCT).Methods A total of 126 patients with gynecological diseases who underwent cervical cancer screening and hospitalization in Xingtai City Rehabilitation Hospital from May 2015 to May 2017 were selected. All patients underwent colposcopy and pathological biopsy and were divided into normal group(normal or cervical inflammation group, 51 cases), CINI group(30 cases), CINII group(25 cases), CINIII group(20 cases). To detect the expression of YAP and AEG-1 protein in patients with different diseases and to compare the clinical indexes of patients with different diseases. To compare the diagnostic efficacy of YAP, AEG-1 protein combined with LCT in the diagnosis of cervical cancer precancerous lesions by ROC curve. Results The positive expression rates of YAP in the control group, CINI group, CINII group and CINIII group were 11.8 %, 36.7 %, 52.0 %, and 75.0 %, respectively. The differences were statistically significant(χ~2=29.085, P<0.01). The control group, CINI group, The positive expression rates of AEG-1 protein in CINII group and CINIII group were 3.9 %, 26.7 %, 80.0 %, and 95.0 %, respectively, and the differences were statistically significant(χ~2=72.400, P<0.01). According to LCT, there were 73 cases of cervical epithelial tumor, 9 cases of atypical squamous epithelial cells, 15 cases of low grade squamous intraepithelial neoplasia, 29 cases of highly squamous intraepithelial neoplasia, and 0 cases of squamous cell carcinoma. The predicted value was 96.2 %; the sensitivity, negative predictive value and area under the ROC curve of YAP, AEG-1 protein combined with LCT were significantly higher than those of each index(P<0.05). Conclusion YAP and AEG-1 protein detection have guiding significance in the screening of cervical cancer precancerous lesions. As the degree of cervical lesions worsened, the expression rates of YAP and AEG-1 proteins gradually increased. YAP, AEG-1 protein combined with LCT detection can help to improve the sensitivity of clinical diagnosis.
引文
[1] Mittal S,Basu P,Muwonge R,et al.Risk of high-grade precancerous lesions and invasive cancers in high-risk HPV-positive women with normal cervix or CIN 1 at baseline-A population-based cohort study [J].International Journal of Cancer,2017,140(8):1850-1859.
[2] VAN BAARS R,GRIFFIN H,WU Zhonglin,et al.Investigating diagnostic problems of CIN1 and CIN2 associated with high-risk HPV by combining the novel molecular biomarker PanHPVE4 with P16INK4a [J].The American Journal of Surgical Pathology,2015,39(11):1518-1528.
[3] 刘国强,张朝红,谢映君,等.高危型人乳头瘤病毒联合液基细胞学检测在宫颈癌前病变筛查中的应用 [J].中国计划生育和妇产科,2015,7(6):43-45.
[4] 徐又先,袁林,濮德敏,等.宫颈癌中抑癌基因FHIT表达与HPV 16基因状态 [J].现代妇产科进展,2016,25(3):182-186.
[5] STEINHARDT A A,GAYYED M F,KLEIN A P,et al.Expression of Yes-associated protein in common solid tumors [J].Human Pathology,2008,39(11):1582-1589.
[6] 卢琪芸,王运根,单江静.AEG-1基因及E-cadherin蛋白在宫颈病变中的表达及意义 [J].中华全科医学,2015,13(10):1650-1652.
[7] 中华人民共和国国家卫生和计划生育委员会.宫颈癌及癌前病变规范化诊疗指南(试行)[J].中国医学前沿杂志(电子版),2013,5(8):40-49.
[8] 马俊如,唐国珍,樊元春,等.子宫颈液基细胞学检查TBS诊断的价值 [J].中国生育健康杂志,2014,25(2):126-128.
[9] LI L,JIANG W,ZENG S-y,et al.Prospective study of hTERC gene detection by fluorescence in situ hybridization (FISH) in cervical intraepithelial neoplasia 1 natural prognosis [J].European Journal of Gynaecological Oncology,2014,35(3):289-291.
[10] XIAO Hong,WU Lin-a,ZHENG Hui-xia,et al.Expression of Yes-Associated protein in cervical squamous epithelium lesions [J].International Journal of Gynecological Cancer,2014,24(9):1575-1582.
[11] 陈海林,方彩云,张春莲.Yes相关蛋白,细胞周期蛋白D1在宫颈癌前病变与宫颈鳞癌中的表达 [J].中国妇幼保健,2017,32(16):3922-3924.
[12] 陈红球,施晓,钱立勇.液基薄层细胞学检测技术及传统宫颈细胞涂片在宫颈癌筛查中的临床应用对比研究 [J].中国性科学,2016,25(10):39-41.
[13] 彭晶晶,王荣敏,尤志学.对ASCCP 2012年宫颈癌筛查和癌前病变管理指南的解读 [J].国际妇产科学杂志,2015,42(1):116-120.
[14] ROSSI E D,MARTINI M,STRACCIA P,et al.The potential of liquid-based cytology in lymph node cytological evaluation:the role of morphology and the aid of ancillary techniques [J].Cytopathology :Official Journal of the British Society for Clinical Cytology,2016,27(1):50-58.
[15] REBOLJ M,RASK J,VAN BALLEGOOIJEN M,et al.Cervical histology after routine ThinPrep or SurePath liquid-based cytology and computer-assisted reading in Denmark [J].British Journal of Cancer,2015,113(9):1259-1274.
[2] VAN BAARS R,GRIFFIN H,WU Zhonglin,et al.Investigating diagnostic problems of CIN1 and CIN2 associated with high-risk HPV by combining the novel molecular biomarker PanHPVE4 with P16INK4a [J].The American Journal of Surgical Pathology,2015,39(11):1518-1528.
[3] 刘国强,张朝红,谢映君,等.高危型人乳头瘤病毒联合液基细胞学检测在宫颈癌前病变筛查中的应用 [J].中国计划生育和妇产科,2015,7(6):43-45.
[4] 徐又先,袁林,濮德敏,等.宫颈癌中抑癌基因FHIT表达与HPV 16基因状态 [J].现代妇产科进展,2016,25(3):182-186.
[5] STEINHARDT A A,GAYYED M F,KLEIN A P,et al.Expression of Yes-associated protein in common solid tumors [J].Human Pathology,2008,39(11):1582-1589.
[6] 卢琪芸,王运根,单江静.AEG-1基因及E-cadherin蛋白在宫颈病变中的表达及意义 [J].中华全科医学,2015,13(10):1650-1652.
[7] 中华人民共和国国家卫生和计划生育委员会.宫颈癌及癌前病变规范化诊疗指南(试行)[J].中国医学前沿杂志(电子版),2013,5(8):40-49.
[8] 马俊如,唐国珍,樊元春,等.子宫颈液基细胞学检查TBS诊断的价值 [J].中国生育健康杂志,2014,25(2):126-128.
[9] LI L,JIANG W,ZENG S-y,et al.Prospective study of hTERC gene detection by fluorescence in situ hybridization (FISH) in cervical intraepithelial neoplasia 1 natural prognosis [J].European Journal of Gynaecological Oncology,2014,35(3):289-291.
[10] XIAO Hong,WU Lin-a,ZHENG Hui-xia,et al.Expression of Yes-Associated protein in cervical squamous epithelium lesions [J].International Journal of Gynecological Cancer,2014,24(9):1575-1582.
[11] 陈海林,方彩云,张春莲.Yes相关蛋白,细胞周期蛋白D1在宫颈癌前病变与宫颈鳞癌中的表达 [J].中国妇幼保健,2017,32(16):3922-3924.
[12] 陈红球,施晓,钱立勇.液基薄层细胞学检测技术及传统宫颈细胞涂片在宫颈癌筛查中的临床应用对比研究 [J].中国性科学,2016,25(10):39-41.
[13] 彭晶晶,王荣敏,尤志学.对ASCCP 2012年宫颈癌筛查和癌前病变管理指南的解读 [J].国际妇产科学杂志,2015,42(1):116-120.
[14] ROSSI E D,MARTINI M,STRACCIA P,et al.The potential of liquid-based cytology in lymph node cytological evaluation:the role of morphology and the aid of ancillary techniques [J].Cytopathology :Official Journal of the British Society for Clinical Cytology,2016,27(1):50-58.
[15] REBOLJ M,RASK J,VAN BALLEGOOIJEN M,et al.Cervical histology after routine ThinPrep or SurePath liquid-based cytology and computer-assisted reading in Denmark [J].British Journal of Cancer,2015,113(9):1259-1274.