Darwiche N, Celli G, Sly L, Lancillotti F, De Luca L M
Laboratory of Cellular Carcinogenesis and Tumor Promotion, National Cancer Institute, NIH, Bethesda, Maryland 20892.
Cancer Res. 1993 May 15;53(10 Suppl):2287-99.
We describe an animal model to induce the histogenesis of squamous metaplasia of the cervical columnar epithelium, a condition usually preceding cervical neoplasia. This model is based on dietary retinoid depletion in female mice. Control sibling mice fed the same diet but with all-trans-retinoic acid (at 3 micrograms/g diet) showed the normal endocervical epithelial and glandular columnar morphology, typical of a simple epithelium without subcolumnar reserve cells. The stratified squamous ectocervical epithelium of these mice fed all-trans retinoic acid showed intense immunohistochemical staining in basal and suprabasal cells with mono-specific antibodies against keratins K5, K14, K6, K13, and, suprabasally, with antibodies specific for K1 and K10. At the squamocolumnar junction, the adjacent columnar epithelium (termed "suprajunctional") did not show staining for K5, K14, K6, K13, K1, and K10 but specifically stained for keratin K8, typical of simple epithelia and absent from the adjacent ectocervical squamous stratified lining (termed "subjunctional"), in striking contrast. Sections of the squamocolumnar junction from mice kept on the vitamin A-deficient diet for 10 weeks showed suprajunctional isolated patches of reserve cells, proximal and distal to the junction. These cells were detected prior to any symptoms of vitamin A deficiency, such as loss of body weight or respiratory discomfort. The subcolumnar reserve cells induced by vitamin A deficiency displayed positive staining for K5 and K14. As deficiency became severe, the reserve cells occupied the entirety of the suprajunctional basement membrane. This epithelium eventually became stratified and squamous metaplastic, the squamocolumnar junction was no longer discernible, and the entire endocervical epithelium and the endometrial glands lost K8 positivity, while acquiring K5, K14, K6, K13, K1, and K10 keratins typical of the ectocervix under normal conditions of vitamin A nutriture. Vitamin A deficiency also altered keratin expression and localization in squamous subjunctional epithelium. In situ hybridization studies for K1 and K5 mRNA showed their major site of expression at the basal (K5) and immediately suprabasal (K1) cell layers. The localization of both K5 and K1 proteins in these same cell layers, and above, is consistent with transcriptional regulation of these keratins. Early vitamin A deficiency caused the appearance of single subcolumnar reserve cells expressing K5 mRNA. After these cells grew into a squamous focus, K1 mRNA became expressed suprabasally. We conclude that retinoid status plays a key role in maintaining differentiative characteristics of the cervical and glandular epithelia and, as such, may be a modulating factor in the development of cervical cancer.
我们描述了一种诱导宫颈柱状上皮鳞状化生组织发生的动物模型,这种情况通常先于宫颈癌发生。该模型基于雌性小鼠饮食中类视黄醇缺乏。喂食相同饮食但添加全反式视黄酸(3微克/克饮食)的对照同窝小鼠显示出正常的宫颈内膜上皮和腺柱状形态,这是典型的无柱状下储备细胞的单层上皮。这些喂食全反式视黄酸的小鼠的分层鳞状宫颈外膜上皮在基底细胞和基底上层细胞中用针对角蛋白K5、K14、K6、K13的单特异性抗体显示出强烈的免疫组织化学染色,在基底上层则用针对K1和K10的特异性抗体染色。在鳞柱交界处,相邻的柱状上皮(称为“交界上”)未显示K5、K14、K6、K13、K1和K10的染色,但对角蛋白K8有特异性染色,K8是单层上皮的典型特征,而相邻的宫颈外膜鳞状分层内衬(称为“交界下”)则没有,形成鲜明对比。在维生素A缺乏饮食饲养10周的小鼠的鳞柱交界处切片显示,在交界处近端和远端有交界上孤立的储备细胞斑块。这些细胞在出现任何维生素A缺乏症状之前就被检测到了,如体重减轻或呼吸不适。维生素A缺乏诱导的柱状下储备细胞对K5和K14呈阳性染色。随着缺乏变得严重,储备细胞占据了整个交界上基底膜。这种上皮最终变成分层的鳞状化生,鳞柱交界处不再可辨,整个宫颈内膜上皮和子宫内膜腺体失去K8阳性,同时获得在正常维生素A营养条件下宫颈外膜典型的K5、K14、K6、K13、K1和K10角蛋白。维生素A缺乏还改变了鳞状交界下上皮中的角蛋白表达和定位。K1和K5 mRNA的原位杂交研究显示它们主要在基底(K5)和紧邻基底上层(K1)细胞层表达。K5和K蛋白质在这些相同细胞层及以上的定位与这些角蛋白的转录调控一致。早期维生素A缺乏导致出现表达K5 mRNA的单个柱状下储备细胞。这些细胞长成鳞状病灶后,K1 mRNA在基底上层开始表达。我们得出结论,类视黄醇状态在维持宫颈和腺上皮的分化特征中起关键作用,因此可能是宫颈癌发生发展中的一个调节因素。