MIF In Tct Exfoliated Cells Of The Cervix Ascus-hpv ( + ) Expression And Significance Of

Cervical cancer is one of the most common malignancy of women, second only to breast cancer and the second place, according to a number of epidemiological and related research in recent years, the results confirmed the occurrence and development of many cancers associated with inflammation, many tumors form from infected, long-term irritation and chronic inflammation. Now widely used liquid-based thin-layer cytology, ASCUS may be inflammatory reactions or may be precancerous lesions, It has attracted attention that reasonable follow-up and triage ASCUS.Currently HPV testing is used for to triage and monitor ASCUS, although HPV testing is highly sensitive, but there are some false positive and false negative rate. Macrophage migration inhibitory factor (MIF) is a cell factor that is found by Bennet and Bloom and other in research delayed hypersensitivity in 1966. There are reports speculated that MIF may be a connection point of inflammation and cancer, MIF lead to cancer by inhibiting the expression of p53. Human papillomavirus (HPV) is a major risk factor for cervical cancer.Objective: Detecting the expression of MIF and p53 in exfoliated cervical cells that result of TCT is ASCUS and corresponding tissue by immunohistochemistry, analyzing the relevance of MIF and p53 and the coincidence between the cytology and histology positive rate. Observed the expression of MIF in the ASCUS-HPV (+) and HPV (-), and to analyze cervical lesions caused by MIF increased whether related to infection of HPV or not; Evaluating the practicality of MIF in triaging and following-up ASCUS.Methods:Collecting 80 Residual TCT between October 2009 and December 2010 that treatment in obstetrics and gynecology clinic of the First Affiliated Hospital of Shanxi Medical University, parallel HPV-DNA testing, colposcopy, have Pathological findings, including ASCUS-HPV (+):40例, ASCUS-HPV (-): 40 cases.And 15 residual samples of TCT that were normal. Centrifuged residual specimens of TCT had been collected,and embedded in paraffin blocks made of cells. Collecting 80 corresponding tissue samples in which includes CIN I/ inflammation:56 cases; CIN II:16 cases; CINIII:8 cases. Detecting the expression of MIF, p53 in each group by immunohistochemistry,and analysizing the correlation between MIF and p53. Statistical analysis using SPSS 17.0 statistical software, using X2 test, Fisher's exact test, Spearman rank correlation analysis, it is significantly different when P≤0.05.Results:1. MIF and p53 of the normal group were not expressed, positive expression rates of MIF and p53 in the ASCUS were significantly higher than normal, respectively 35.0%,,20.0%, positive expression rates between the two groups were significantly different (P<0.05). The positive expression rate of MIF and p53 in the tissue gradually increased with disease severity increased, positive expression rates of MIF and p53 in CINⅠ/inflammation. CINⅡ,CINIII, respectively:MIF:28.6%.62.5%,75.0%, p53:3.6%,31.3%.87.5%, the positive expression rate in CINⅡ, CINⅢwere significantly increased compared with CINⅠ/inflammation, there was significant difference (P＜0.0125), there was not significant difference (P> 0.0125) between CINⅡand CINIII. Analysizing the correlation between expression of MIF and p53 in the appropriate organization by Spearman correlation analysis (r=0.444,P=0.000), positive correlation between the two. The detection rate of MIF was higher compared with p53 in the early precancerous lesions (CINⅠ/inflammation, CIN II), while the detection rate of p53 was higher than MIF in CINIII, suggesting that MIF prompted cervical lesions was earlier than p53.2. To compare the expression of MIF and P53 in the cell blocks and tissue:The positive rate has not significant difference in the cell blocks and tissue (P> 0.05), and the degree of agreement is strongly (k> 0.7).3. The positive expression rate of MIF in the ASCUS-HPV (+) were significantly higher than HPV (-),respectively:52.5%(21/40),20.0%(8/40), there was significant difference (P <0.05), suggesting that elevated MIF expression lead to cervical lesions may be associated with HPV infection. On which the HPV (+)-MIF (+), HPV (-)-MIF (+), HPV (+)-MIF (-), HPV (-)-MIF (-) corresponding histopathological results, in which the percentage of≥CINⅡwere 85.7%,62.5%,5.3%,3.1%, suggesting that MIF can increase the detection of HSIL in the ASCUS-HPV (+).Conclusion:(1). The trend of MIF, p53 was the positive with cervical lesions increased, and a positive correlation between the MIF and p53. (2). The expression of MIF and p53 in the prepared blocks of cells that result was ASCUS can reflect the expression of the organization to some extent. (3). MIF can increases detection rate of high lesions in the ASCUS-HPV (+). (4). MIF may be marker for triaging and following-up the ASCUS.When the result of TCT is ASCUS, and HPV (+), and showed diffuse expression of MIF in exfoliated cervical cells,patients as soon as possible to perform a cervical biopsy under the colposcopy to definite histological diagnosis, so that's to the early diagnosis of cervical lesions and treatment.