Expression Of Skp2 And P27 Protein And Their Correlations With Clinicopathological Features Of Invasive Cervical Carcinoma

Objective:To study the expression and correlation of Skp2 and P27 in cervical carcinoma and their relationships with clinicopathological features and prognosis. Methods:Immunohistochemical SP technique was used to detect the expressions of Skp2 and P27 in 65 cases of invasive cervical carcinoma and 20 cases of cervical intraepithelial neoplasia(CIN). The relationship of Skp2 and P27 expression with clinicopathological features and prognosis in cervical carcinoma was then analysed. The correlation between Skp2 and P27 was also studied. 60 cases of normal cervical tissue were taken as control group. Results:1. Skp2 expressed mainly in nucleus. The rate of positive expression of Skp2 in cervical carcinoma was 55.4% ,remarkably higher than 25.0% in CIN (P=0.017) and 6.7% in normal cervical tissue (P=0.000), which differences were statistically significant. Skp2 expression in CIN was remarkably higher than that in normal tissue with a difference of statistical significant.2. Positive rate of Skp2 protein in cervical carcinoma became higher when tumor differentiation degree went poorer. The positive rate of Skp2 protein in well and moderately differentiated carcinoma was 39.4%, whereas it was 67.6% in poorly differentiated carcinoma, which difference was statistically significant (P=0.023).3. The expression of Skp2 had significant correlation with tumor infiltrating depth, intravascular involvement and lymph node metastasis, which difference was significant in statistics(P < 0.01),whereas no relationships of itwith age, clinical stage and tumor size were observed (P > 0.05).4. 5-year survival rate of cervical carcinoma in positive Skp2 expression group (52.78%) was remarkably lower than that of Skp2 negative group (68.93%), Log- rank=8.60, P=0.0034 by Kaplan-Meier survival rate analysis, which indicated a strong relationship of Skp2 expression with cervical carcinoma prognosis.5. The staining of P27 was mainly confined to nucleus but a mild expression was observed in cytoplasm in cervical invasive carcinoma. The rate of positive expression of P27 in cervical carcinoma was 52.3%, remarkably lower than 85.0% in CIN (P=0.009) and 98.3% in normal cervical tissue (P=0.000), which difference was statistically significant. P27 expression in CIN was remarkably lower than that of normal tissue, which difference was statistically significant(.P=0.018).6. Positive rate of P27 protein in cervical carcinoma became lower when tumor differentiation degree went poorer. The positive rates of P27 protein in well and moderately differentiated carcinoma and poorly differentiated carcinoma were 67.9% and 40.5% respectively, which difference was statistically significant (P=0.029).7. The expression of P27 had remarkable correlation with tumor infiltrating depth, intravascular involvement and lymph node metastasis, which difference was statistically significant(P< 0.05), whereas no relationship of it with age, clinical stage and tumor size was observed(P > 0.05).8. 5-year survival rate of cervical carcinoma in negative P27 expression group (58.38%) was remarkably lower than that of P27 positive group (70.59%), Log- rank=8.33, p=0.0039 by Kaplan-Meier survival rate analysis, which indicated a strong relationship of P27 expression with cervical carcinoma prognosis.9. Spearman's rank correlation test showed that Skp2 expression in cervical carcinoma had negative correlation with P27 expression.Correlation coefficient: r=-0.311,P=0.015.The negative correlation between Skp2 andP27 was observed also in CIN(r=-0.728,P=0.000) and in normal cervical tissues(r=-0.487,P=0.001). Conclusion:1. Skp2 expressed low in normal cervical tissue,higer in CIN and higest in cervival carcinoma. Skp2 became gradually higer in expression when the degree of tumor differentiation became poorer.2. P27 expressed high in normal cervical tissue,a little lower in CIN and lowest in cervival carcinoma. P27 became gradually lower in expression when the degree of tumor differentiation became poorer.3. The expressions of Skp2 and P27 had remarkable correlations with malignant behaviors such as tumor infiltration depth, intravascular involvement and lymph node metastasis.A negative correlation was observed between two of them.Over expression of Skp2 along with low expression of P27 may indicate a tumor with higher invasive tendency and poor prognosis.4. Combined detection of the expressions of Skp2 and P27 had an important value in the evaluation of malignant potential and prognosis of cervical carcinoma.5. Skp2 and P27 can be used as the independent indicators for the prognosis of cervical carcinoma and provide a new target to the treatment of cervical carcinoma.