Lin W M, Michalopulos E A, Dhurander N, Cheng P C, Robinson W, Ashfaq R, Coleman R L, Muller C Y
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235, USA.
Clin Cancer Res. 2000 Apr;6(4):1410-4.
Epidemiological studies have documented the unpredictable clinical progression or recurrence of cervical dysplasia. Recent studies have shown several molecular changes in cervical cancers and their associated dysplasia. We conducted molecular analyses on a retrospectively ascertained cohort of recurrent and nonrecurrent cervical dysplasia cases in an attempt to define molecular biomarkers to predict progressive or recurrent disease. Cases were chosen if long-term follow-up (3-5 years after conization) and biopsy confirmation were available. Paraffin-embedded, postconization cervical tissues from 19 recurrent and 18 nonrecurrent dysplasias were analyzed. Human papillomavirus (HPV) was identified by PCR for general and type-specific (HPV-16 and HPV-18) primers. Allelotyping analysis was performed by multiplex PCR using a panel of 16 microsatellite markers targeting putative tumor suppressor gene regions on chromosomes 3p, 5p, 6p, 9p, 11q, and 17p. The overall rate of HPV infection was similar in both groups. In the allelotyping analysis, loss of heterozygosity at the fragile histidine triad region in 3p14.2 was significantly higher in the recurrent group than in the nonrecurrent group (P = 0.005). Furthermore, microsatellite alterations (MAs) were more frequent in the recurrent group (mean MA index, 0.254) as compared with the nonrecurrent group (mean MA index, 0.085; P = 0.0025). These findings suggest that HPV status alone does not predict recurrence and that loss of heterozygos. ity at the fragile histidine triad region may represent a potential biomarker in predicting recurrence. Frequent MAs in the recurrent group may represent an underlying genomic instability that creates susceptibility for allelic loss, thus increasing the risk for recurrence or progression.
流行病学研究记录了宫颈发育异常不可预测的临床进展或复发情况。近期研究显示宫颈癌及其相关发育异常存在多种分子变化。我们对一组经回顾性确定的复发性和非复发性宫颈发育异常病例进行了分子分析,试图确定预测疾病进展或复发的分子生物标志物。若有长期随访(锥切术后3至5年)及活检确认结果,则纳入病例。分析了19例复发性和18例非复发性发育异常的锥切术后宫颈石蜡包埋组织。通过针对通用引物和型特异性引物(HPV - 16和HPV - 18)的聚合酶链反应(PCR)鉴定人乳头瘤病毒(HPV)。使用一组针对染色体3p、5p、6p、9p、11q和17p上假定肿瘤抑制基因区域的16个微卫星标记,通过多重PCR进行等位基因分型分析。两组的HPV总体感染率相似。在等位基因分型分析中,复发性组在3p14.2处脆性组氨酸三联体区域的杂合性缺失显著高于非复发性组(P = 0.005)。此外,与非复发性组(平均微卫星改变指数,0.085;P = 0.0025)相比,复发性组的微卫星改变(MAs)更为频繁(平均MA指数,0.254)。这些发现表明,仅HPV状态不能预测复发,而脆性组氨酸三联体区域的杂合性缺失可能是预测复发的潜在生物标志物。复发性组中频繁的MAs可能代表一种潜在的基因组不稳定性,其导致等位基因缺失易感性增加,从而增加复发或进展的风险。