目的 探究宫颈癌癌组织及外周血单个核细胞(PBMC)中黑色素瘤相关抗原-A3(MAGE-A3)表达及临床意义。方法 通过方便抽样选取2020-05至2022-05保定市妇幼保健院及河北大学附属医院收治的因宫颈病变拟行宫颈锥切术或广泛性子宫切除术患者96例,根据术后病理结果分为宫颈癌组和子宫颈鳞状上皮内病变(SIL)组,采用免疫组化法检测病变组织MAGE-A3蛋白表达情况。采用实时荧光定量PCR法检测宫颈病变组织及PBMC中MAGE-A3 mRNA表达水平,分析宫颈癌患者癌组织及PBMC中MAGE-A3mRNA表达与血清肿瘤标志物相关性以及癌组织MAGE-A3蛋白表达与临床病理特征关系。结果 宫颈癌癌组织MAGE-A3蛋白表达阳性率与FIGO分期、肿瘤的直径大小、分化程度、淋巴结转移、感染高危型HPV有关(P<0.05),与年龄、病理类型无关(P>0.05)。宫颈癌组癌组织和PBMC中MAGE-A3 mRNA表达水平分别为(1.33±0.46)、(1.70±0.49),均显著高于SIL组(0.59±0.20、0.92±0.33)(P<0.05),血清SCC-Ag[(3.87±1.69)ng/ml]、CA-125[(48.62±15.10)U/ml]均显著高于SIL组[(0.70±0.32)ng/ml、(25.36±8.33)U/ml](P<0.05);宫颈癌组癌组织MAGE-A3蛋白表达阳性率(66.07%)显著高于SIL组(30.00%)(P<0.05);宫颈癌患者癌组织、PBMC中MAGE-A3 mRNA表达水平与血清SCC-Ag、CA-125均呈正相关(P<0.05)。结论 宫颈癌患者癌组织及PBMC中MAGE-A3表达均上调,且与患者血清肿瘤标志物水平及病情进展有关,MAGE-A3有望成为早期宫颈癌诊断的重要标志物。
Abstract
Objective To investigate the expression and clinical value of melanoma-associated antigen-A3 (MAGE-A3) in cervical cancer tissues and peripheral blood mononuclear cells (PBMC). Methods A total of 96 patients with cervical conectomy or extensive hysterectomy due to cervical lesions from Baoding Maternal and Child Health Hospital and the Affiliated Hospital of Hebei University from May 2020 to May 2022 were selected by convenient sampling, and divided into cervical cancer group (56 cases) and cervical squamous intraepithelial lesion (SIL) group (40 cases) according to postoperative pathological results. Immunohistochemical method was used to detect the expression of MAGE-A3 protein in the pathological tissues. Real-time fluorescent quantitative PCR method was used to detect the expression level of MAGE-A3mRNA in cervical lesion tissues and PBMC, and to analyze the correlation between the expression of MAGE-A3 mRNA in cancer tissues and PBMC of cervical cancer patients and serum tumor markers, as well as the relationship between the expression of MAGE-A3 protein in cancer tissues and clinicopathological characteristics. To explore the diagnostic value of MAGE-A3 mRNA expression in cancer tissue and PBMC for cervical cancer. Results The positive rate of MAGE-A3 protein expression in cervical cancer tissue was correlated with FIGO stage, tumor diameter, differentiation degree, lymph node metastasis and infection with high-risk HPV (P<0.05), but not with age or pathological type (P>0.05). The mRNA expression levels of MAGE-A3 in cancer tissue and PBMC in cervical cancer group were (1.33±0.46) and (1.70±0.49), respectively, which were significantly higher than those in SIL group (0.59±0.20) and PBMC group (0.92±0.33) (P<0.05). Serum levels of SCC-Ag[(3.87±1.69) ng/ml] and CA-125[(48.62±15.10) U/ml] were significantly higher than those of SIL group [(0.70±0.32) ng/ml, (25.36±8.33) U/ml] (P<0.05). The expression positive rate of MAGE-A3 protein in cervical cancer group (66.07%) was significantly higher than that in SIL group (30.00%) (P<0.05). The mRNA expression levels of MAGE-A3 in cancer tissue and PBMC of patients with cervical cancer were positively correlated with serum SCC-Ag and CA-125 (P<0.05). Conclusions The expression of MAGE-A3 in cancer tissue and PBMC of patients with cervical cancer is up-regulated, and it is related to the level of serum tumor markers and disease progression of patients. MAGE-A3 is expected to be an important marker for the diagnosis of early cervical cancer.
关键词
宫颈癌 /
黑色素瘤相关抗原-A3 /
外周血单个核细胞 /
子宫颈鳞状上皮内病变
Key words
cervical cancer /
melanoma associated antigen-A3 /
peripheral blood mononuclear cell /
cervical squamous intraepithelial lesion
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