Saegusa M, Takano Y, Hashimura M, Shoji Y, Okayasu I
Department of Pathology, School of Medicine Kitasato University, Kanagawa, Japan.
Cancer. 1995 Dec 1;76(11):2297-303. doi: 10.1002/1097-0142(19951201)76:11<2297::aid-cncr2820761118>3.0.co;2-b.
A close link between human papillomavirus (HPV) and the development of uterine cervical neoplasias has been proposed. However, other cofactors also are required for malignant transformation.
Forty-six cervical intraepithelial neoplasias (CIN) I/II, 75 CIN III, and 60 invasive squamous cell carcinomas (ISCC) were investigated by immunohistochemical staining for bcl-2 protein (bcl-2), bax protein (Bax), estrogen receptor (ER), and progesterone receptor (PR). The presence of HPV-DNA was examined using the polymerase chain reaction assay.
bcl-2 immunoreactivity was found in 17 of 46 (37%) CIN I/II, 48 of 75 (64%) CIN III, and 12 of 60 (20%) ISCC, the positivity in CIN III being significantly higher than in CIN I/II or ISCC (P < 0.004, P = 0.0001). The bcl-2 immunostaining pattern could be subdivided into two groups, basal type and diffuse type, with the incidence of the latter being clearly increased, in line with tumor progression. In the Bax or HPV-DNA positive groups, bcl-2 positive cases in CIN I/II were in the minority, whereas in CIN III they constituted the majority. In ISCC, bcl-2 positive was significantly lower than negative cases, not being associated with Bax and HPV-DNA. Estrogen receptor and PR immunoreactivity were rare.
These results indicate that bcl-2 may play an important role in a relatively early stage of cervical tumorigenesis, in association with Bax expression and HPV infection.
已提出人乳头瘤病毒（HPV）与子宫颈肿瘤形成之间存在密切联系。然而，恶性转化还需要其他辅助因素。
通过免疫组织化学染色检测46例宫颈上皮内瘤变（CIN）I/II、75例CIN III和60例浸润性鳞状细胞癌（ISCC）中的bcl-2蛋白（bcl-2）、bax蛋白（Bax）、雌激素受体（ER）和孕激素受体（PR）。采用聚合酶链反应检测HPV-DNA的存在情况。
在46例CIN I/II中有17例（37%）、75例CIN III中有48例（64%）、60例ISCC中有12例（20%）发现bcl-2免疫反应性，CIN III中的阳性率显著高于CIN I/II或ISCC（P < 0.004，P = 0.0001）。bcl-2免疫染色模式可分为两组，即基底型和弥漫型，随着肿瘤进展，后者的发生率明显增加。在Bax或HPV-DNA阳性组中，CIN I/II中的bcl-2阳性病例占少数，而在CIN III中则占多数。在ISCC中，bcl-2阳性显著低于阴性病例，且与Bax和HPV-DNA无关。雌激素受体和PR免疫反应性罕见。
这些结果表明，bcl-2可能在宫颈肿瘤发生的相对早期阶段与Bax表达和HPV感染相关，发挥重要作用。
