IL-6在宫颈上皮内瘤变和宫颈癌中的表达及意义

发布时间：2018-04-01 12:13

本文选题：IL-6　切入点：宫颈上皮内瘤变　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:研究白细胞介素6(IL-6)在不同病变级别的宫颈上皮内瘤变和宫颈癌中的表达,分析IL-6在宫颈病变进展中的作用以及作为临床预警指标的实用价值。方法:收集2014年8月到2017年2月山西医科大学第二医院妇科阴道镜室177例患者的血清、阴道灌洗液及宫颈组织活检样本,其中慢性宫颈炎45例,低度鳞状上皮内瘤变(LSIL)45例,高度鳞状上皮内瘤变(HSIL)47例,宫颈癌40例,用于本研究。采用酶联免疫吸附试验(ELISA)双抗体夹心法检测IL-6蛋白在不同组别患者的血清、宫颈组织局部微环境及组织中的表达。采用荧光PCR(RT-PCR)定量检测IL-6在组织中的表达,计算其相对表达量。结果:ELISA结果显示:血清检测中,慢性宫颈炎组的IL-6浓度虽低于宫颈癌组,但高于其他癌前病变组,呈现相对较高的水平,组间比较结果示,除外慢性宫颈炎组和HSIL组无统计学差异,其余各组两两比较均有统计学差异;分析血清中IL-6蛋白浓度与宫颈上皮内瘤变和宫颈癌的关系结果显示,除外慢性宫颈炎组,LISL、HSIL、宫颈癌的IL-6蛋白浓度随病变程度的升高而呈现递增的趋势。ELISA结果显示:组织局部微环境检测中,慢性宫颈炎所测IL-6浓度最低,宫颈癌组最高,组间比较结果显示,各组两两比较均有统计学差异;分析组织中IL-6蛋白浓度与宫颈上皮内瘤变和宫颈癌的关系结果显示,相对慢性宫颈炎而言,IL-6蛋白的浓度随病变级别的升高而呈递增趋势;结合宫颈上皮内瘤变和宫颈癌发生的多种因素,灌洗液IL-6、家族肿瘤史、持续感染HR-HPV起重要作用;IL-6/IL-2的值随着病变程度的增加而增大,灌洗液中IL-6与IL-10的相关性不大。组织中IL-6测定结果显示:随病变程度的增加,组织中IL-6表达增加,逆转录荧光定量PCR结果显示:组织中IL-6m RNA随着病变级别的升高而表达量增加,其中在宫颈癌中表达量最高,进行组间两两比较结果显示,除LSIL与HSIL两组间差异无统计学意义外,其余各组两两比较均有统计学差异。分析血清中与组织中IL-6蛋白表达的相关性结果显示,二者相关性不大。结论:慢性宫颈炎和HSIL组血清IL-6病变差异无统计学意义,血清IL-6不能指示疾病的发展变化;随病变级别升高,宫颈组织局部微环境中IL-6表达递增,可与灌洗液IL-2结合作为一种预警指标指示宫颈疾病的发展;组织IL-6表达有差异,但IL-6m RNA在LSIL组与HSIL组无统计学差异,不适合作为预测CIN发展的生物指标。
[Abstract]:Objective: to study the expression of interleukin-6 (IL-6) in cervical intraepithelial neoplasia and cervical carcinoma with different pathological grades. To analyze the role of IL-6 in the progression of cervical lesions and its practical value as a clinical early warning index. Methods: from August 2014 to February 2017, the serum samples of 177 patients in gynecological colposcopy room of the second Hospital of Shanxi Medical University were collected. Among them, 45 cases were chronic cervicitis, 45 cases were low grade squamous intraepithelial neoplasia, 47 cases were high grade squamous intraepithelial neoplasia, and 40 cases were cervical carcinoma. To detect the expression of IL-6 protein in serum, local microenvironment and tissue of different groups of patients by Elisa. Fluorescence PCR RT-PCR) was used to quantitatively detect the expression of IL-6 in different groups of patients. Results the IL-6 concentration of chronic cervicitis group was lower than that of cervical cancer group, but higher than that of other precancerous lesion group. Except chronic cervicitis group and HSIL group, there was no statistical difference between the two groups, and there were statistical differences in the other groups. The relationship between serum IL-6 protein concentration and cervical intraepithelial neoplasia and cervical cancer was analyzed. Except for the chronic cervicitis group, the IL-6 protein concentration of cervical cancer showed an increasing trend with the increase of pathological degree. Elisa results showed that the IL-6 concentration in chronic cervicitis group was the lowest, and that in cervical cancer group was the highest. The results showed that there were statistical differences between the two groups, and the relationship between the concentration of IL-6 protein and cervical intraepithelial neoplasia and cervical cancer was analyzed. Compared with chronic cervicitis, the concentration of IL-6 protein increased with the increase of pathological grade, combined with many factors of cervical intraepithelial neoplasia and cervical cancer, IL-6 in lavage fluid, family tumor history, The level of IL 6 / IL 2 increased with the increase of pathological degree, but the correlation between IL-6 and IL-10 in the lavage fluid was not significant. The results of IL-6 assay showed that the expression of IL-6 increased with the increase of the degree of lesion. The results of reverse transcription-fluorescence quantitative PCR showed that the expression of IL-6m RNA increased with the increase of pathological grade, and the expression of IL-6m RNA was the highest in cervical cancer. The results of comparison between groups showed that there was no significant difference between the two groups except LSIL and HSIL. The correlation between the expression of IL-6 protein in serum and tissue was not significant. Conclusion: there is no significant difference in serum IL-6 between chronic cervicitis and HSIL. Serum IL-6 can not indicate the development and change of the disease, and the expression of IL-6 in local microenvironment of cervical tissue increases with the increase of pathological grade, which can be combined with lavage fluid IL-2 as a warning indicator to indicate the development of cervical disease, and the expression of IL-6 in tissue is different. However, IL-6m RNA had no statistical difference between LSIL group and HSIL group, so it was not suitable to be used as a biomarker to predict the development of CIN.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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