研究脆性组胺三联体(fragile histidine triad, FHIT)蛋白和增殖细胞核抗原(proliferating cell nuclear antigen, PCNA)蛋白在宫颈涂片中的表达及在宫颈癌前病变诊断中的意义。

选取2004年6月至2005年6月在兰州大学第一医院妇科门诊宫颈计算机辅助细胞学检测涂片(computer-assisted cytology test, CCT)为低度鳞状上皮内病变(low-grade squamous intraepithelial lesion, LSIL)(74例)和高度鳞状上皮内病变(high-grade squamous intraepithelial lesion, HSIL)(40例)的可疑宫颈病变患者114例，采用免疫组化法检测患者宫颈组织中脆性组胺三联体、增殖细胞核抗原蛋白的表达情况。

脆性组胺三联体蛋白在正常宫颈上皮中表达，在宫颈上皮内瘤变(cervical intraepithelial neoplasia, CIN)及宫颈癌中表达缺失，在宫颈上皮内瘤变Ⅰ、宫颈上皮内瘤变Ⅱ、宫颈上皮内瘤变Ⅲ及宫颈癌组织中，其表达缺失率分别为13.3%,30.0%,60.0%和71.4%。增殖细胞核抗原蛋白在宫颈上皮内瘤变及宫颈癌中表达升高，在宫颈上皮内瘤变Ⅰ、宫颈上皮内瘤变Ⅱ、宫颈上皮内瘤变Ⅲ及宫颈癌组织中，其阳性表达率分别为44.7%,60.0%,80.0%,85.7%，而且其染色强度明显升高。各组间脆性组胺三联体蛋白、增殖细胞核抗原蛋白表达率比较，差异有显著意义(P=0.0001)。

脆性组胺三联体蛋白表达缺失，是宫颈癌发生的早期事件，其表达缺失程度与宫颈上皮内瘤变的分级有关，高级别的癌前病变缺失率明显增高；增殖细胞核抗原蛋白的表达，在宫颈癌前病变中逐级增高，可用于评估癌前病变的恶变潜能。

To investigate the expression of fragile histidine triad(FHIT)protein and proliferating cell nuclear antigen(PCNA)protein in cervical smears, and the clinical diagnostic significance in precancerous cervical lesions.

74 cases of low-grade squamous intraepithelial lesion(LSIL)and 40 cases of high-grade squamous intraepithelial lesion(HSIL)(from June 2004 to June 2005, the Department of Obstetrics and Gynecology, First Hospital of Lanzhou University)were enrolled in this study. The expression of fragile histidine triad protein and proliferating cell nuclear antigen protein were examined in those 114 cervical tissues by immunochistochemistry.

Fragile histidine triad protein was detected in normal cervical tissue and the absence rate of fragile histidine triad in cervical intraepithelial neoplasia(CIN)and cervical cancer. The absence rate in CINⅠ,CINⅡ, CIN Ⅲ and cervical cancer tissue were 13.3%,30.0%, 60.0% and 71.4%, respectively. The expression of proliferating cell nuclear antigen protein in CIN and cervical cancer was increased and its positive expression rate in CINⅠ,CIN Ⅱ,CIN Ⅲ and cervical cancer tissue were 44.7%,60.0%, 80.0%,85.7%,respectively. Chi-square test supported the loss rate of fragile histidine triad protein and positive rate of proliferating cell nuclear antigen protein(P=0.0001)at different pathological stages with statistical significance in contrast to the control group.

The loss of fragile histidine triad protein expression occurs in the early stage of cervical carcinogenesis, which related with CIN grades. The activation of proliferating cell nuclear antigen protein is obviously higher in precancerous cervical lesions. The expression of fragile histidine triad protein and proliferating cell nuclear antigen protein can be used for assessing the malignant potential of precancerous lesions.