The Expression And Clinical Significance Of ILK, HIF-1α, E-cadherin And P16 In Cervical Carcinoma

Objective:To study the expression and clinical significance of ILK, HIF-1α, E-cadherin and p16 in normal cervical epithelium, cervical intraepithelial neoplasia(CIN) and cervical carcinoma.Methods:The expression of ILK, HIF-1α, E-cadherin and p16 in 112 pathological specimens was detected by Immunohistochemistry. The specimens were all obtained by cervical biopsy or excision, including 16 cases of CINⅠ,38 cases of CINⅡ～Ⅲand 38 cases of cervical carcinoma.Results:①From normal cervical epithelium to CIN and then to cervical carcinoma, the positive expression rate of ILK showed gradual increase. The rate in cervical carcinoma was apparently higher than in CINⅡ～Ⅲ, and that in CINⅠwas apparently higher than in normal cervical epithelium(P＜0.05). The expression of ILK did not correlate with the patients' age, FIGO staging, degree of differentiation and lymph node metastasis(P＞0.05). The reason might be related to the insufficient cases and false-positive results.②From normal cervical epithelium to CIN and then to cervical carcinoma, the positive expression rate of HIF-la increased gradually. There was almost no expression of HIF-1αin normal cervical epithelium. The expression in CINⅠwas apparently lower than in CINⅡ～Ⅲ(P＜0.05), while that in CINⅡ～Ⅲwas apparently lower than in cervical carcinoma(P＜0.01). And the expression of HIF-1αdid not correlate with the patients' age, but did with FIGO staging, degree of differentiation and lymph node metastasis. The expression in the cervical carcinoma StageⅢandⅣ, moderately or poorly differentiated and with lymph node metastasis was apparently higher than in that StageⅠandⅡ, well differentiated and without lymph node metastasis(P＜0.01). ③The positive expression rate of E-cadherin showed a decreasing trend in turn in normal cervical tissues, CINⅠ, CINⅡ～Ⅲand cervical carcinoma. The rate in normal cervical tissues was apparently higher than in CINⅠ(P＜0.05), and in CINⅠapparently higher than in cervical carcinoma(P＜0.05). With the clinical stage increased, the positive expression rate of E-cadherin decreased. By comparison of different degree of differentiation, the positive rate was lower with the poorer differentiation of the cancer cells. Besides, the positive expression rate in the cervical carcinoma with lymph node metastasis was apparently higher than without(P＜0.01). For the age factor, it had no correlation with the expression(P＞0.05).④The expression of p16 showed a increasing trend in turn in normal cervical tissues, CINⅠ, CINⅡ～Ⅲand cervical carcinoma. The positive expression rate in normal cervical tissues was apparently lower than in CINⅠ(P＜0.05), and in CINⅠwas apparently lower than in cervical carcinoma(P＜0.05). There was no significant difference within each of the groups of age, FIGO staging and lymph node metastasis(P＞0.05). In the cervical carcinoma with different degree of differentiation, the poorer the degree was, the higher the positive expression rate of p16 was.⑤The positive expression rate of ILK, HIF-1αand p16 had negative correlation with that of E-cadherin.Conclusion:①As a better cell proliferation marker, ILK has certain reference value for the discrimination of normal cervical epithelium, CIN at all levels and cervical carcinoma. But whether it has correlation with the biological behaviour and the degree of malignancy of cervical carcinoma, and whether it helps clinical assessment of prognosis of patients with cervical cancer, needs to further research and follow-up.②The detection and research of HIF-1αwould contribute to early and differential diagnosis of cervical carcinoma, and predict the development trend and metastatic potential of tumors. It is expected to be a new clinical diagnostic criteria and tumor marker. HIF-la/E-cadherin pathway also exists in cervical carcinoma, and further research on the expression and regulation mechanism of HIF-1α/E-cadherin will provide important clues to the diagnosis and treatment of cervical carcinoma.③Abnormal expression of E-cadherin has a hand in the occurrence of cervical carcinoma. Reduced expression of E-cadherin in cervical carcinoma correlates with the over expression of ILK, HIF-1α, p16 and such signaling molecules. This shows that a variety of signaling molecules together with E-cadherin play a part in malignant transformation of cell during the cancerization of cervix. To detect the expression of various signaling molecules together with E-cadherin makes sense to understand the occurrence and development mechanism of cervical carcinoma.④The expression of p16 in cervical carcinoma is apparently higher than that in normal cervical mucosa. And it changes early in the tumor, so it is an early event. To regard detection of p16 as a secondary screening for precancerous lesions of uterine cervix, would help us to judge CIN, to reduce the rate of misdiagnosis of cervical cancer, and so to take early and timely treatment.