Department of Pathology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
Department of Pathology, Guangdong Medical University, Guangdong, Dongguan, China.
Int J Exp Pathol. 2023 Jun;104(3):140-150. doi: 10.1111/iep.12470. Epub 2023 Mar 16.
The aim of this study was to investigate the correlation between Silva pattern system and clinicopathological features of endocervical adenocarcinoma. Moreover, it was to find molecular markers helpful for Silva classification, and thus we also explored the expression levels of invasion, adhesion and proliferation biomarkers in cases of Silva non-invasive and invasive types. The survival based on Silva pattern system was analysed by Kaplan-Meier survival analysis, Log-rank test and a COX risk proportionality model. Sixty samples were chosen to detect the MMP-2, MMP-9, u-PA, E-cadherin, β-catenin, EGF, TGF-α, HDGF, c-Met and RGN expression by immunohistochemistry. Multivariate analysis showed that pattern A/pattern B/pattern C Silva pattern system provided independent risk factors for prognosis. Our results found the levels of MMP-2, MMP-9 and u-PA were significantly higher in endocervical adenocarcinoma with destructive growth than in the nondestructive group. The levels of E-cadherin and β-catenin were significantly lower in endocervical adenocarcinoma with destructive growth than in the nondestructive group. The levels of EGF, TGF-α and HDGF were significantly higher in endocervical adenocarcinoma with destructive growth than in the nondestructive group. Compared with 'non-invasive/invasive Silva pattern', this study suggests 'pattern A/pattern B/pattern C Silva pattern' could be a better criteria for predicting the prognosis. Furthermore, the dual-marker combination of 'MMP-2 and u-PA' and 'E-cadherin and β-catenin' is very important in the diagnosis of Silva pattern classification.
本研究旨在探讨 Silva 模式系统与宫颈内膜腺癌临床病理特征的相关性。此外，还旨在寻找有助于 Silva 分类的分子标志物，因此我们还探讨了 Silva 非浸润性和浸润性类型病例中侵袭、黏附和增殖生物标志物的表达水平。通过 Kaplan-Meier 生存分析、Log-rank 检验和 COX 风险比例模型分析基于 Silva 模式系统的生存情况。选择 60 例样本，通过免疫组织化学法检测 MMP-2、MMP-9、u-PA、E-钙黏蛋白、β-连环蛋白、EGF、TGF-α、HDGF、c-Met 和 RGN 的表达。多变量分析表明，A 型/B 型/C 型 Silva 模式系统为预后的独立危险因素。我们的结果发现，在具有破坏性生长的宫颈内膜腺癌中，MMP-2、MMP-9 和 u-PA 的水平明显高于非破坏性组。在具有破坏性生长的宫颈内膜腺癌中，E-钙黏蛋白和β-连环蛋白的水平明显低于非破坏性组。在具有破坏性生长的宫颈内膜腺癌中，EGF、TGF-α 和 HDGF 的水平明显高于非破坏性组。与“非浸润/浸润性 Silva 模式”相比，本研究表明“A型/B 型/C 型 Silva 模式”可能是预测预后的更好标准。此外，“MMP-2 和 u-PA”与“E-钙黏蛋白和β-连环蛋白”的双重标志物组合在 Silva 模式分类的诊断中非常重要。
