Expression And Clinical Significance Of IGFBP-5 And CFLIP In CIN And Cervical Cancer

Objective:To investigate the expression of insulin-like growth binding protein 5(IGFBP-5), cellular Fas-associated death domain-like interleukin-1β-converting enzyme(FLICE)-like nhibitory protein(cFLIP)in cervical intraepithelial neoplasia(CIN)and cervical cancer and to evaluate their clinical significances.Methods:The expression of IGFBP-5,cFLIP in cervical tissue samples were detected by Reverse Transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry (IHC).The research group was made up of 37 cases of CIN and 40 cases of cervical cancer tissues.Control group contained 28 cases of normal cervical tissue.The CIN group included 11 cases of CIN,13 cases of CINⅡand 13 cases of CINⅢ.CINⅠwas low grade squamous intraepithial lesion,and CINⅡ/Ⅲwas high grade squamous intraepithial lesion.Clinical staging of SCC was determined according to the criteria of the International Federation of Gynecology and Obstetrics,including 26 cases of stage-Ⅰand 14 cases of stage-Ⅱ.There were 24 cases of well-differentiated,16 cases of moderately and poorly differentiated cases according to the postop pathological certification.Results:①The expression of IGFBP-5:The expression of IGFBP-5 protein was located in cytoplasm,stained buffy.In control group,20 out of 28 cases(71.43%)were seen the positive expression.The positive expression of IGFBP-5 protein in CINⅠwas 72.73%(8/11),with 100%(26/26)in CINⅡ/Ⅲ.The positive rate in cervical cancer decreased to 45.00%(18/40).It had a sigfinicant difference in cervical cancer group compared with control group and CIN group(P＜0.05).The expression of IGFBP-5 had relationships with pathological staging,cell differentiation and lymph node metastasis:the positive rate in cases with lymphatic metabasis(16.67%)was lower than that in cases without lymphatic metabasis(53.14%).The positive rate in cases of pathological stagingⅡ(21.43%)was lower than that in cases of pathological stagingⅠ(57.69%)and in well-differentiated cases(25.00%)was lower than that in poorly and moderately differentiated cases(75.00%)(P＜0.05).The expression of IGFBP-5 mRNA in control group,CINⅠ,CINⅡ/Ⅲ,and tumor tissue were 0.2124±0.0795,0.4210±0.0624,1.0500±0.0875,0.3600±0.0575 desperately.The overexpression of IGFBP-5 was seen in CIN group,expecially in CINⅡ/Ⅲ.The expression of IGFBP-5 in CINⅡ/Ⅲwas higer than that in cervical cancer and control group, which had significant differences(P＜0.05).②The expression of cFLIP:The expression of cFLIP protein was located in cytoplasm,stained buffy.In control group,the positive rate was 21.43%(6/28).We can see the up-regulated expression in CIN group and cervical cancer group.The positive rate in CINⅠwas 36.36%and 76.92%in CINⅡ/Ⅲ.It had significant difference between this two groups(P＜0.05).The positive rate in cervical cancer, 82.50%(33/40),was the highest compared with the control group and CINⅠgroup. There was no difference between CINⅡ/Ⅲgroup and cervical cancer group(P＞0.05). The expression in cervical cancer had correlation with pathological staging.The positive rate in cases of well-differentiated(70.83%)was lower than that of poorly and moderately differentiated(100%)(P＜0.05).The expression of cFLIP mRNA in control group,CINⅠ,CINⅡ/Ⅲand tumor tissue were 0.0246±0.0100,1.0523±0.0230,3.0426±0.0819,6.8874±0.6663 respectively,with a tendency of up-regulated expression.There were significant differences among these groups(P＜0.05).Conclusions:1 The expression of IGFBP-5 was up-regulated compensationly in the precancerosis,which induced the intrinsic apoptotic pathway and postponed the progress of the tumor. 2 the expression of IGFBP-5 in cervical cancer was lower than that in control group and CIN group,which inhibit the apoptotic pathway and promoted the tumor growth.3.Compared with control group and CIN group,the expression of cFLIP in cervical cancer was up-regulated,which can promote the proliferation of tumor cells.4.To dectect of the expression of IGFBP-5 and cFLIP can help us to evaluate the pathogenetic condition in CIN and cervical cancer.