The Expression Of Transcriptional Positive Coactivator 4 And P53 Protein In Cervical Squamous Cell Carcinoma And Its Correlation To Chemoradiotherapy Sensitivity

Objective:To detect the expression of human transcriptional positive coactivator 4(PC4)and p53 protein in chronic cervicitis,Cervical intraepithelial neoplasia(CIN)and cervical squamous cell carcinoma(SCC)tissues,analyse the relationships between the expression of two proteins and the Clinicopathological features in SCC group,and the correlation between the expression of two proteins in SCC,explore the mechanisms of PC4 and p53 in the occurrence and development of SCC.Evaluate the efficacy of concurrent chemoradiotherapy(CCRT)for advanced SCC,analyse the relationships between the expression of two proteins and the efficacy of CCRT,explore the relationship between the expression of two proteins and sensitivity to CCRT.Methods:Immunohistochemical(IHC)method(Envision)was used to detect the expression of PC4 and p53 proteins in 16 cases of chronic cervicitis,19 cases of CIN and 90 cases of SCC.Clinical,pathological datas were collected,the efficacy of CCRT for advanced SCC was evaluated.Using SPSS19.0 software,analyzing the relationship between the expression of two proteins and the different of cervical lesions,the clinicopathological features for SCC,the sensitivity to CCRT for advanced SCC.Enumeration data analyzed by ?2 test or Fisher's exact probability,mutiple sample means analyzed by F test,hierarchical data analyzed by Rank sum test.Spearman rank correlation was used for correlation analysis.Results:1.PC4 and p53 protein both could expressed in chronic cervicitis,CIN and SCC tissues,both located in the nucleus.The IHC staining of PC4 is pale brown,the percentage of positive cells is 0-100%.The IHC staining of p53 protein is brown,the percentage of positive cells is 0-30%.2.The positive expressin rate of PC4 in chronic cervicitis,CIN and SCC tissues were respectively93.75%,89.47%,83.33%,there were no difference(P>0.05),but the expression degrees has statistically significant(?2=6.386,P=0.041).The positive expression rate of P53 protein in chronic cervicitis,CIN and SCC tissues were respectively 6.25%,15.79%,48.89%,there were significant difference(?2=15.284,P<0.001).3.In SCC tissues,the correlation between the expression degrees of PC4 and patient age,FIGO stage,differentiation degree,myometrial invasion,tumor size and vascular invasion,there were no difference(P>0.05),but the expression degrees of PC4 closely correlation to lymph node metastasis(?2=2.550,P=0.011);The correlation between the expression degrees of p53 protein and the clinicopathological features,there were no difference(P>0.05).4.Among the 45 cases of advanced SCC,the recent result of CCRT were 32 patients geted complete response(CR),9 patients geted partial response(PR),4 patients geted stable(SD).Tumor size correlated to the sensitivity of CCRT(?2=10.385,P=0.001).The expression of PC4 between the highly and lowly sensitive group has statistically significant(Z=2.236,P=0.025),the expression of p53 protein between the highly and lowly sensitive group has statistically significant(Z=2.289,P=0.022).5.There was positive correlation between the expression of PC4 and p53 protein in SCC(r=0.507,P<0.001).Conclusion:1.The positive rate of PC4 in chronic cervicitis,CIN and SCC tissues has no significant difference,but the expression degrees has statistically significant,the expression degrees of PC4 related with Lymph node metastasis.Suggesting that the activation of PC4 may be involved in the occurrence,development of SCC,and may play an important role in the invasion and metastasis of SCC.2.The positive rate of p53 protein in chronic cervicitis,CIN and SCC tissues rise gradually with the severity lesions.However there aren't any clear associations between the expression of p53 protein and the clinical pathological indicators.Suggesting that the activation of p53 protein may be one of the reason in the occurrence of SCC.3.The positive expression of PC4 and p53 protein had a higher rate in the higly sensitive group than lowely group.Suggesting that PC4 and p53 protein may be related to the sensitivity to CCRT in advanced SCC.Tumor size maybe an independent factor that affecting the sensitivity.4.There was positive correlation between the expression of PC4 and p53 protein in SCC.The result suggested that the two proteins in the initiation and progression of SCC may have asynergistic effect.