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目的探讨Mdm2癌基因、PTEN抑癌基因和细菌L型感染在卵巢肿瘤中的表达及临床意义,并分析它们之间的相互影响和协同作用。方法应用免疫组化、原位杂交和革兰染色等方法检测97例卵巢乳头状癌及23例卵巢乳头状瘤组织中Mdm2、PTEN的表达及细菌L型检出率,并用χ2检验进行统计学处理。结果卵巢恶性肿瘤中Mdm2蛋白和基因的表达率均明显高于良性肿瘤(P<0.0001～0.0005)。Mdm2蛋白和基因的表达在卵巢乳头状癌中临床分期Ⅲ、Ⅳ期的表达率明显高于Ⅰ、Ⅱ期(P<0.005);随着病理分级增高而显著增加(P<0.005);腹腔淋巴结有转移、有腹水比无转移者、无腹水者差异有显著性(P<0.01～0.05),呈正相关。PTEN蛋白及基因的表达在卵巢良性肿瘤均明显高于恶性肿瘤,病理分级Ⅰ、Ⅱ级的阳性表达率明显高于Ⅲ级;临床分期Ⅰ、Ⅱ期中的阳性表达率明显高于Ⅲ、Ⅳ期(P<0.001～0.005);腹腔淋巴结无转移者、无腹水者比有转移、有腹水差异有显著性(P<0.01～0.05),呈负相关。细菌L型检出阳性率与病理分级、临床分期差异有显著性(P<0.05),腹腔淋巴结有转移、有腹水比无转移者、无腹水者差异有非常显著性(P<0.01)。结论Mdm2、PTEN基因在卵巢肿瘤中有不同程度的异常表达,两种基因均可作为判断卵巢肿瘤生物学行为及患者预后参考指标。L型感染极有可能导致基因的变异或过表达,因此L型感染可能成为诱发肿瘤形成的原因之一。细菌L型感染可能诱导PTEN抑癌基因、Mdm2癌基因的变异和异常表达以及它们相互协同在卵巢肿瘤发生和发展过程中起重要作用。
Objective To investigate the expression and clinical significance of Mdm2 oncogene, PTEN tumor suppressor gene and bacterial L-type infection in ovarian neoplasms and to analyze their interaction and synergism. Methods The expression of Mdm2, PTEN and the detection rate of bacterial L-type in 97 cases of ovarian papillary carcinoma and 23 cases of ovarian papilloma were detected by immunohistochemistry, in situ hybridization and Gram stain, and the results were analyzed by χ2 test deal with. Results The expression of Mdm2 protein and gene in ovarian cancer was significantly higher than that in benign tumors (P <0.0001 ~ 0.0005). The expression of Mdm2 protein and gene in stage Ⅲ and Ⅳ ovarian papillary carcinoma was significantly higher than that in stage Ⅰ and Ⅱ (P <0.005), and significantly increased with the pathological grade (P <0.005). The expression of Mdm2 protein and gene in celiac lymph node There was a significant difference (P <0.01 ~ 0.05) in metastasis, ascites compared with those without metastasis and without ascites, which showed a positive correlation. The positive expression rates of PTEN protein and gene in benign ovarian tumors were significantly higher than those in malignant tumors, the positive rates of pathological grade Ⅰ and Ⅱ were significantly higher than those in grade Ⅲ. The positive rates of PTEN in stage Ⅰ and Ⅱ were significantly higher than those in stage Ⅲ and Ⅳ (P <0.001-0.005). There was a significant difference (P <0.01-0.05) in ascites between patients with and without ascites due to metastasis of abdominal lymph nodes. The positive rate of bacterial L-type detection was significantly different from that of pathological grade and clinical stage (P <0.05). There was a significant difference in the metastasis of abdominal lymph nodes between patients with ascites and without ascites (P <0.01). Conclusions Mdm2 and PTEN genes are abnormally expressed in ovarian tumors in varying degrees, both of which can be used as a reference index to judge the biological behavior of ovarian tumors and the prognosis of patients. L type infection is most likely to lead to gene mutation or overexpression, so L infection may be one of the reasons inducing tumor formation. L-type bacterial infection may induce PTEN tumor suppressor gene, Mdm2 oncogene variation and abnormal expression and their mutual cooperation in ovarian tumor plays an important role in the occurrence and development.