子宫颈癌前病变和鳞状癌中特定主要组织相容性复合体抗原表达的改变。

Chil Arkadiusz, Sikorski Marek, Bobek Małgorzata, Jakiel Grzegorz, Marcinkiewicz Janusz

Department of Gynecologic Oncology, Kielce Oncology Center, Kielce, Poland.

Acta Obstet Gynecol Scand. 2003 Dec;82(12):1146-52. doi: 10.1046/j.1600-0412.2003.00252.x.

BACKGROUND

The objective of the study was to determine whether there is a correlation between expression of selected major histocompatibility complex (MHC) antigens and the presence of carcinoma and premalignant lesions of the cervix. We also attempted to determine whether there is a correlation between expression of the selected MHC antigens in each grade of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix.

METHODS

Quantitative comparative analysis of MHC class I and class II expression between specimens of the uterine cervix was carried out. For detecting human leukocyte antigen (HLA) class I molecules, two primary antibodies were used, recognizing either epitopes of all free heavy chain class I molecules or epitopes of the HLA-Bw4 antigen. HLA class II antigens were detected by antibodies reacting with the alpha-chain of the HLA-DR molecule. An indirect immunoperoxidase technique was carried out using paraffin-embedded sections. The following groups of sections were formed: squamous metaplasia, CIN of different grades, and invasive carcinoma. The specimens were taken from women in whom routine histopathologic diagnosis of cervical lesions had been performed.

RESULTS

A significant decrease in the mean number of stained cells showing expression of MHC class I antigens (HC 10 and Bw4) was found in the invasive cancer group of specimens. A decrease in Bw4 expression was also found in the CIN III group. The highest expression of the HLA-DR antigens was detected in the metaplastic epithelium compared to the other groups. In the dysplastic epithelium the expression of the HLA-DR antigens was increased in the highest grade of dysplasia (CIN III). Upregulation of HLA-DR expression was detected in invasive cancer specimens.

CONCLUSIONS

Alterations in MHC expression are found in premalignant lesions and squamous carcinomas of the uterine cervix. Quantitative assessment with the use of an image analysis system is valuable in helping to discriminate staining patterns of HLA expression. Further studies are indicated to evaluate the prognostic value of the expression of selected MHC antigens.

背景

本研究的目的是确定所选主要组织相容性复合体（MHC）抗原的表达与子宫颈癌及癌前病变的存在之间是否存在相关性。我们还试图确定所选MHC抗原在各等级宫颈上皮内瘤变（CIN）和子宫颈浸润癌中的表达之间是否存在相关性。

方法

对子宫颈标本中MHC I类和II类表达进行定量比较分析。为检测人类白细胞抗原（HLA）I类分子，使用了两种一抗，分别识别所有游离重链I类分子的表位或HLA - Bw4抗原的表位。HLA II类抗原通过与HLA - DR分子α链反应的抗体进行检测。使用石蜡包埋切片进行间接免疫过氧化物酶技术。形成了以下几组切片：鳞状化生、不同等级的CIN和浸润癌。标本取自已进行宫颈病变常规组织病理学诊断的女性。

结果

在标本的浸润癌组中，显示MHC I类抗原（HC 10和Bw4）表达的染色细胞平均数显著减少。在CIN III组中也发现Bw4表达减少。与其他组相比，化生上皮中检测到HLA - DR抗原的最高表达。在发育异常上皮中，HLA - DR抗原的表达在最高等级的发育异常（CIN III）中增加。在浸润癌标本中检测到HLA - DR表达上调。