口腔黏膜癌前病变癌变过程中端粒酶逆转录酶mRNA和增殖细胞核抗原的表达及其相关性

目的　探讨人端粒酶逆转录酶 (hTERT)mRNA和增殖细胞核抗原 (PCNA)在口腔黏膜癌前病变癌变发生发展中的作用 ,以及hTERTmRNA与PCNA蛋白表达之间的关系及意义。方法　应用原位杂交和免疫组化法对口腔黏膜单纯性增生 (HP)9例 ,轻度异常增生 (LD) 11例 ,中度异常增生 (MD) 10例 ,重度异常增生 (即原位癌 ,CIS) 9例 ,鳞癌 (SCC) 11例 ,进行hTERTmR NA及PCNA蛋白检测 ,结果应用计算机图像分析系统分析。结果　口腔黏膜上皮从HP、LD、MD到CIS、SCC ,hTERT、PCNA蛋白的阳性细胞面积指数及吸光度 (A)值均逐渐上升 ,鳞癌最高。在HP及LD ,hTERT、PCNA阳性细胞主要位于基底层 ,但随着细胞异常增生程度的加重 ,阳性表达细胞从基底层向角化层进展。在高分化鳞癌中 ,主要分布在癌巢周边 ,分化较差的鳞癌则散布于整个肿瘤组织中。PCNA与hTERTmRNA表达呈线性正相关。结论　hTERT与PCNA均参与口腔黏膜癌前病变癌变的发生发展过程 ;PCNA与hTERTmRNA表达的正相关 ,表明hTERT激活细胞多处于高增殖状态。

Relationship between PCNA Protein and hTERTmRNA Expression in Pre-malignant Lesions of Oral Mucosa and Its Significance

Objective To investigate the roles of hTERTmRNA and PCNA protein in malignant changes of oral mucosal precancerous lesions and the relationship between hTERTmRNA and PCNA. Methods The expressions of hTERTmRNA and PCNA were detected by in situ hybridization and immunohistochemical technique in 9 cases of oral mucosal hyperplasia, 11 cases of light dysplasia, 10 cases of medium dysplasia, 9 cases of carcinomas in situ and 11 cases of squamous cell carcinomas. The analysis of the results was conducted by medical photographic system. Results From hyperplasia, light dysplasia, medium dysplasia to carcinomas in situ and squamous cell carcinomas, the indexes of positive cell vessels and the value of A increased, arriving at the apex in squamous cell carcinoma groups. hTERT and PCNA expression cells were mainly located within stratum basale in hyperplasia and light dysplasia groups, but with phenotypic progression and the degree of dysplasia, expression cells extended from basal layer to the keratinous layer. In highly-differentiated squamous cell carcinomas, expression cells were mainly pericancerous. Stained cells dispersed throughout the tumor tissue in low-differentiated squamous cell carcinomas. The expression of hTERTmRNA was linear positively related to that of PCNA protein. Conclusion Activation of telomerase and PCNA plays a role in the process of malignant changes of oral mucosal precancerous lesions. Quantitive analyses of above indexes are of crucial clinical significance.