Expression And Significance Of A-SMA?MMP-2 And BFGF Of The Stromal Cells In Microinvasive Carcinoma Of Cervix

BackgroundThe incidence and mortality of cervical cancer were ranked fourth in female malignant tumors,and ranked second in female reproductive system tumors,only behind the breast cancer.WHO statistics show that the number of new cervical cancer cases in 2012 was about 528000,compared with 266000 cases of deaths.The regional incidence of cervical cancer is quite different and 70%of the new cases are concentrated in developing countries,of which China's new cases and deaths accounted for about 11.7%and 11.1%.According to China's national cancer center data released in 2015,new cases of cervical cancer and deaths are expected to reach 98900 cases and 30500 cases,showing a clear upward trend,contrary to the developed countries.Therefore,it's of great significance to find effective methods to screen out CIN,MIC,cervical invasive carcinoma,and take targeted intervention.Studies have shown that ?-Smooth Muscle Actin(?-SMA)is highly expressed in breast cancer,nasopharyngeal carcinoma,oral cancer and other interstitial fibroblasts.Matrix metalloproteinase-2(MMP-2)is up-regulated in cervical cancer and pancreatic cancer with the increase of pathological grade.The expression of Basic fibroblast growth factor(bFGF)in cervical cancer,non small cell lung cancer,breast cancer,colon cancer,thyroid cancer and gastric cancer increased with the increase of pathological grade.It indicates that they play a very important role in the occurrence and progression of the tumor.However,there are few studies on the expression of three antibodies in the interstitial substance of MIC and CIN?.ObjectiveTo detect the expression of a-SMA.MMP-2 and bFGF in the stromal cells of the normal cervix,cervical intraepithelial neoplasia III,microinvasive carcinoma of cervix,and to investigate their expression in tumorigenesis and development in and the significance in the differential diagnosis between CIN? and MIC.MethodsA total of 110 specimens of hysterectomy or conization were collected from Qilu Hospital of Shandong University and Dong e People's Hospital from January 2008 to October 2015.The normal cervical tissue resected by uterine fibroids or adenomyosis was selected as the control.Immunohistochemical two-steps was used to detect the expression levels of a-SMA,MMP-2 and bFGF in 30 cases of normal cervix,50 cases of CIN?,30 cases of MIC.HE slices and immunohistochemical sections of all cases were judged by two high-grade pathology physicians.The Greenspan semi-quantitative method was used to evaluate the staining intensity and color percentage.Statistical analysis were performed by using SPSS 18.0 statistics software.Grade data use cases and percentage.Groups were compared using non-parametric statistical Kruskal-Wallis test.The correlation analysis between the indexes was analyzed by Spearman correlation analysis.P<0.05 was statistically significant.Resultsa-SMA in the fibroblasts around the tumor foci in the interstitium of CIN ? group and MIC group is diffuse positive,and is no expression in the control group.The difference between the two groups was statistically significant(X2=55.14,P<0.001).MMP-2 was mainly located in the cytoplasm,and the positive rate of expression in the fibroblasts of the interstitium in control group,CIN ? group and MIC group was gradually increased and the difference was statistically significant(X2=51.90,P<0.001).The positive reaction of bFGF protein was mainly located in cytoplasm.With the progression of disease,the positive expression rate increased gradually,and the expression rate of bFGF protein was significantly different(X2 =13.40.,P<0.001),but the expression was weakly positive,suggesting that the sensitivity is lower than the former two antibodies.Spearman rank correlation analysis showed that there was a positive correlation between MMP-2 expression and a-SMA expression in the stroma(rs =0.324,p<0.05).ConclusionsThe expression of ?-SMA?MMP-2 and bFGF in the stromal cells among normal cervix,CINIII,MIC was statistically significant.There was a positive correlation between MMP-2 expression and a-SMA expression in the stroma(rs=0.324,p<0.05).They can be used in conjunction with the diagnosis and differential diagnosis of MIC.