자궁경부 종양에서 p53, Proliferating Cell Nuclear Antigen(PCNA), c-myc 및 Epidermal Growth Factor Receptor(EGFR)의 발현 = Exprssion of p53, Proliferating Cell Nuclear Antigen(PCNA), c-myc, and Epidermal Growth Factor Receptor(EGFR) in Cervical Neoplasia

다국어 초록 (Multilingual Abstract)

Expression of four biologic markers known as p53, proliferating cell nuclear antigen(PCNA), c-myc, and epidermal growth factor receptor(EGFR), was studied immunohistochemically in 121 cases of cervical tissues, which included 15 cases of normal cervical tissues, 50 cases of squamous intraepithelial lesions(SIL), and 56 cases of invasive carcinomas. This study was designed to elucidate the roles of these factors in the genesis and progression of cervical neoplasia and to identify their association with clinical parameters such as cell type, tumor size, lymph node involvement, squamous cell carcinoma(SCC) antigen level, and prognosis. In additon, this study evaluates the differences of coexpression rates in normal cervical tissues, SILs, and invasive carcinomas. (1) The intensities of p53, c-myc, and EGFR expression and the rates of PCNA, c-myc, and EGFR expression in cervical SILs and invasive carcinomas were significantly higher than those in normal tissues (p<0.05 and p<0.01). But there were no significant differences between SILs and invasive carcinomas in both of intensities and rates of p53, PCNA, c-myc, and EGFR expression. (2) The intensities and rates of p53, PCNA, and c-myc expression in the invasive carcinomas did not correlate with clinical parameters including cell types, tumor sizes, lymph node involvements, see antigen, and prognosis. But only the intensity and rate of EGFR expression were significantly higher in cases with tumor size larger than 3 cm when it was compared with cases with tumor sizes smaller than 3 cm(p<0.01), in cases with lymph node involvement when it was compared with cases without lymph node involvement(p<0.05), and in cases with SCC antigen levels more than 2.5 ng/ml when it was compared with cases with SCC antigen levels less than 2.5 ng/ml(p<0.05). (3) C-myc immunoreactivity was significantly correlated with EGFR overexpression(p<0.01). (4) The rates of simultaneous expression of four factors were decreased significantly in normal tissues and significantly increased in invasive carcinomas(p<0.01). The coexpression rate of two factors or more was 6.7% in normal tissues, 62.7% in SILs, and 70.0% in invasive carcinomas and the simultaneous expression rate of three factors or more was none in normal tissues, 34.0% in SILs, and 47.5 % in invasive carcinomas. These results show that the immunohistochemical detection of p53, PCNA, c-myc, and EGFR expression will be useful in differentiating the normal tissues and cervical neoplasia. The results of simultaneous immunohistochemical detection of these four factor expression also suggest to contribute a better understanding of the genesis of cervical carcinoma and that coexpression of more factors indicate more aggressiveness in cervical neoplasia, and show that simultaneous detection of these factors can be used in the early detection of cervical neoplasia and to predict malignant transformation of cervical lesions.