전암단계 병변의 증식능, 클론성 및 불멸성에 관한 검토 - 자궁경부 상피병변을 중심으로 -
Assay of Proliferative Activity, Clonality and Immortality if Precancerous Lesions of the Uterine Cervix
김형석, 이영직, 김미숙, 고향미, 정상우,
소속 상세정보
김형석 ( Kim Hyung-Seok )
전남대학교 의과대학 병리학교실
이영직 ( Lee Young-Jik )
전남대학교 의과대학 병리학교실
김미숙 ( Kim Mee-Sook )
전남대학교 의과대학 병리학교실
고향미 ( Ko Hyang-Mi )
보훈병원 해부병리과
정상우 ( Juhng Sang-Woo )
전남대학교 의과대학 병리학교실
KMID : 0357919990330090652
Abstract
Among the precancerous lesions, dysplasia of the uterine cervix and adenoma of the colon have been widely studied in terms of genetic alterations. However, little has been performed regarding phenotypic alterations of the precancerous lesions. We investigated the relationship among cellular proliferation, clonality, immortality and histopathologic grading of the squamous epithelial lesions of the uterine cervix. Proliferation index (PI) was calculated based on the ratio of the epithelial cells positive for proliferating cell nuclear antigen to the total epithelial cells. Clonality was assayed by X-linked HUMARA polymorphism. For immortality assay, PCR-based TRAP (telomeric repeat amplification protocol) was done and telomerase processivity was calculated by comparison with the positive control. PI increased gradually as the lesions advanced from dysplasia to invasive carcinoma. Among informative case, all of the carcinoma in situ showed monoclonal pattern (7 of 7). Among invasive squamous cell carcinoma, 6 cases showed monoclonal pattern and 2 cases polyclonal pattern. TRAP reaction was positive in 92.6% (25 of 27) of dysplasia (high grade: 14 of 15; low grade: 11 of 12), 95.0% (19 of 20) of carcinoma in situ, 100% (9 of 9) of microinvasive carcinoma, and 92.9% (13 of 14) of invasive carcinoma. It was also positive in 12 of 12 samples of chronic cervicitis or squamous metaplasia near the lesions of dysplasia. There was no difference in TRAP positivity among the dysplasia, carcinoma in situ and invasive carcinoma, whereas telomerase processivity showed significant correlation. These results suggest that proliferative activity and telomerase processivity may be progressive events in oncogenesis, although telomerase activation may be an early event.
키워드
Precancerous lesion;Proliferative activity;Clonality;Immortality
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