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Biomedical subjects

S S Liu

Publications and source records attributed to S S Liu.

At least 19 recordsLinked to original sources
PubMed2001

Anti-apoptotic proteins, apoptotic and proliferative parameters and their prognostic significance in cervical carcinoma.

The inhibitor of apoptosis proteins (IAP) suppress apoptosis induced by a variety of stimuli. The aims of this study were to: (a) compare the expression of X-linked IAP (Xiap) and Human IAP-2 (Hiap-2) in cervical carcinoma cells and normal cervix, (b) determine the correlation between IAP expression and tumour apoptosis or proliferation, and (c) assess their prognostic significance in cervical carcinomas. Paraffin-embedded tissue sections were retrieved from 77 patients with cervical squamous carcinomas prior to treatments and 47 normal subjects. Tumour apoptosis was determined by terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuracil triphosphate (dUTP) nick-end labelling (TUNEL) and apoptotic index (AI), and the proliferative rate was measured by Ki-67 and mitotic (MI) indices. Immunoreactive Xiap and Hiap-2 were found in both cervical cancer cells and normal tissues. IAP expressions in cancers did not correlate with apoptotic and proliferative parameters, disease stage and patient survival. The lower AI and Ki-67 index were associated with a better survival. In conclusion, the basal expression levels of IAPs have no prognostic significance, but AI and Ki-67 expression are potential prognostic indicators in cervical carcinoma.

Adult↗
PubMed2001

ADL 8-2698, a trans-3,4-dimethyl-4-(3-hydroxyphenyl) piperidine, prevents gastrointestinal effects of intravenous morphine without affecting analgesia.

ADL-8-2698 is a novel peripherally restricted opioid antagonist that may selectively prevent opioid-induced gastrointestinal effects without reversing analgesia. Gastrointestinal transit time (lactulose hydrogen breath test) was measured in 14 volunteers with oral and intravenous placebo, oral placebo and intravenous morphine (0.05 mg x kg(-1)), and oral ADL 8-2698 (4 mg) and intravenous morphine (0.05 mg x kg(-1)) in a double blind, cross-over study. Morphine prolonged gastrointestinal transit time from 69 to 103 minutes (P = .005); this was prevented by ADL 8-2698 (P = .004). Postoperatively, 45 patients were randomly assigned in a double-blind fashion to receive ADL 8-2698 (4 mg) or placebo and intravenous morphine (0.15 mg/kg) or to receive oral and intravenous placebo. Analgesia and pupil constriction were measured. Morphine analgesia and pupil constriction were unaffected by ADL 8-2698 and differed from placebo (P < .002). We conclude that ADL 8-2698 prevents morphine-induced increases in gastrointestinal transit time by means of selective peripheral opioid anitagonism without affecting central opioid analgesia.

Adult↗
PubMed2001

A comparison of ropivacaine with fentanyl to bupivacaine with fentanyl for postoperative patient-controlled epidural analgesia.

UNLABELLED: Ropivacaine for patient-controlled epidural analgesia (PCEA) may facilitate postoperative patient mobilization because it causes less motor block than bupivacaine. Forty patients undergoing abdominal surgery were randomized in a double-blinded manner to the following: 0.05% bupivacaine/4 microg fentanyl, 0.1% bupivacaine/fentanyl, 0.05% ropivacaine/fentanyl, or 0.1% ropivacaine/fentanyl for standardized PCEA. We measured pain scores, side effects, and PCEA consumption for 42 h. Lower-extremity motor function was assessed with electromyography and isometric force dynamometry. Analgesia was equivalent among groups. Local anesthetic use was more in the 0.1% Ropivacaine and 0.1% Bupivacaine groups (77% increase, P = 0.001). Motor function decreased during PCEA (10%-35% decrease from preoperative, P < 0.001) and was equivalent among groups. Eight patients were transiently unable to ambulate. These patients used more local anesthetic (45 vs 33 mg mean, P < 0.05) with additional decrease in motor function (32%, P < 0.004) compared with ambulating patients. Other side effects were mild and equivalent among solutions. PCEA with bupivacaine/fentanyl and ropivacaine/fentanyl as 0.05% or 0.1% solutions appears clinically equipotent. Lower-extremity motor function decreases, but is unlikely to result in prolonged inability to ambulate. Use of a 0.05% solution may be advantageous to decrease local anesthetic use and prevent transient motor block. IMPLICATIONS: Patient-controlled epidural analgesia with bupivacaine/fentanyl and ropivacaine/fentanyl as either 0.05% or 0.1% solutions are clinically similar. Lower-extremity motor function will decrease with the use of any of these combinations, but is unlikely to result in the inability to walk.

Amides↗
PubMed2001

Epidural lidocaine decreases sevoflurane requirement for adequate depth of anesthesia as measured by the Bispectral Index monitor.

BACKGROUND: Epidural anesthesia potentiates sedative drug effects and decreases minimum alveolar concentration (MAC). The authors hypothesized that epidural anesthesia also decreases the general anesthetic requirements for adequate depth of anesthesia as measured by Bispectral Index (BIS). METHODS: After premedication with 0.02 mg/kg midazolam and 1 microg/kg fentanyl, 30 patients aged 20-65 yr were randomized in a double-blinded fashion to receive general anesthesia with either intravenous saline placebo or intravenous lidocaine control (1-mg/kg bolus dose; 25 microg x kg(-1) x min(-1)). A matched group was prospectively assigned to receive epidural lidocaine (15 ml; 2%) with intravenous saline placebo. All patients received 4 mg/kg thiopental and 1 mg/kg rocuronium for tracheal intubation. After 10 min of a predetermined end-tidal sevoflurane concentration, BIS was measured. The ED50 of sevoflurane for each group was determined by up-down methodology based on BIS less than 50 (MAC(BIS50)). Plasma lidocaine concentrations were measured. RESULTS: The MAC(BIS50) of sevoflurane (0.59% end tidal) was significantly decreased with lidocaine epidural anesthesia compared with general anesthesia alone (0.92%) or with intravenous lidocaine (1%; P < 0.0001). Plasma lidocaine concentrations in the intravenous lidocaine group (1.9 microg/ml) were similar to those in the epidural lidocaine group (2.0 microg/ml). CONCLUSIONS: Epidural anesthesia reduced by 34% the sevoflurane required for adequate depth of anesthesia. This effect was not a result of systemic lidocaine absorbtion, but may have been caused by deafferentation by epidural anesthesia or direct rostral spread of local anesthetic within the cerebrospinal fluid. Lower-than-expected concentrations of volatile agents may be sufficient during combined epidural-general anesthesia.

Adult↗
PubMed2001

Frontotemporal orbitozygomatic craniotomy to exposure the cavernous sinus and its surrounding regions. Microsurgical anatomy.

BACKGROUND: The microsurgical anatomy of the cavernous sinus and its surrounding regions were examined via frontotemporal orbitozygomatic (FTOZ) craniotomy. Combined with other deep osteotomies, the possibility of exposing the petroclival region and basilar artery was also explored. METHODS: The study was made on 20 sides of 10 cadaveric specimens fixed with formalin, with the help of the surgical microscope (magnification 5-15). RESULTS: The FTOZ was performed with frontotemporal and orbitozygomatic flaps. Extradurally, V2, V3, the trigeminal ganglion, the posterior vertical segment of the intracavernous ICA and the VI nerve were exposed by FTOZ craniotomy. By further removal of the petrous apex (Kawase's triangle), exposure could be extended to the petroclival region; with anterior modification of the microscopic light, in 50% of the specimens, exposure reached as low as the convergence of the vertebral arteries. The anterior part of the cavernous sinus and the orbital apex were examined by removing the anterior clinoid process, orbital roof and unroofing the optic canal. Intradurally, the intrapeduncular fossa (upper 1/3 of the clivus) was examined. The intracavernous cranial nerves and vessels were studied via lateral and superior wall approaches. By removing both the anterior and posterior clinoid processes together, in 80% of the specimens, the exposure could be carried as far as the midpoint of the basilar artery. CONCLUSIONS: FTOZ craniotomy could be used to treat lesions involving the cavernous sinus and its surrounding regions. Incorporated with the petrous apectomy, it could be used to expose the petroclival region and, in selected cases, exposure could be extended to the convergence of the vertebral arteries. Combined with anterior and posterior clinoidectomies, it could also be used to treat midpoint regions of the basilar artery.

Basilar Artery↗
PubMed2001

Effect of insulin on oxygen free radicals and oxidative phosphorylation in liver mitochondria of diabetic rats.

AIM: To observe the effects of insulin on liver mitochondrial respiratory function, activity of H+-ATPase, and superoxide anion free radicals production in diabetic rats. METHODS: Rats were injected iv with alloxan 40 mg/kg to induce diabetes. The liver mitochondrial respiratory function was assayed by measurement of oxygen consumption using a Clark oxygen electrode. Superoxide anion production was assayed using chemiluminescence method. Activities of H+-ATPase were measured by luciferin-luciferase system and inorganic phosphorus's method. RESULTS: Insulin 1 U/kg sc daily for 9 weeks improved oxidative phosphorylation, respiratory rate state 3 (P < 0.05), respiratory control ration (P < 0.01), and ADP:O ratio (P < 0.01), but there were no obvious effect on respiratory rate state 4 (P > 0.05). In the insulin group, synthesis activity of H+-ATPase was obviously increased (P < 0.05) and hydrolytic activity of H+-ATPase was remarkably decreased (P < 0.01), compared with the diabetes group. Insulin 1 U/kg for 9 weeks apparently decreased the production of O2.- (P < 0.01) in liver mitochondria of diabetic rats. CONCLUSION: Insulin can prevent the injury from superoxide anion in liver mitochondria, and improve the function of the liver mitochondria oxidative phosphorylation.

Adenosine Triphosphatases↗
PubMed2000

New developments in spinal anesthesia.

Spinal anesthesia can be used effectively and efficiently for a variety of cases in both the inpatient and the ambulatory surgery setting. Choice of agent, dose, distribution, use of adjuncts, and occasionally the use of continuous spinal anesthesia can tailor the spinal anesthetic to a specific type and duration of surgery. Although spinal anesthesia is extremely safe, adherence of new guidelines for patients receiving anticoagulant drugs, LMWH in particular, may minimize the risk of neurologic injury from spinal bleeding. At present, intrathecal adjuncts, such as neostigmine and clonidine used with local anesthetics, have shown limited usefulness, whereas lipophilic opioids, such as fentanyl, appear to increase duration and quality of spinal block without increasing the time to recovery. In the future, shorter-acting local anesthetics, possibly in conjunction with continuous catheter technologies, may reduce recovery times after spinal anesthesia without increasing risk. Spinal agents with long-acting analgesic properties that do not produce sensorimotor deficits may go beyond the immediate perioperative period and relieve postoperative pain. Currently there is controversy surrounding the use of spinal lidocaine and the occurrence of TNS, especially in the outpatient setting. The prudent use of small-dose bupivacaine and possibly procaine may reduce this risk, further supporting the use of spinal anesthesia for ambulatory as well as inpatient surgical procedures.

Adjuvants, Anesthesia↗
PubMed2000

Modelling development time of Lipaphis erysimi (Hemiptera: Aphididae) at constant and variable temperatures.

The development period from birth to adult of virginoparae of the turnip aphid, Lipaphis erysimi (Kaltenbach), at 14 constant, 15 alternating and 15 natural temperature regimes were modelled to determine mathematical functions for simulating aphid development under a wide range of natural conditions. The day-degree model, the logistic equation, and the Wang model were used to describe the relationships between temperature and development rate at constant and alternating temperatures. The three models were then used with a Weibull function describing the distribution of development times, to simulate the development of individuals of cohorts at natural temperature regimes. Comparison of the observed with simulated distributions of adult emergence indicates that all three models can simulate the development of L. erysimi equally well when temperature does not go below 6 degrees C (the notional low temperature threshold of the day-degree model) or above 30 degrees C. When accumulation of temperatures below 6 degrees C becomes substantial, only the logistic curve offers accurate simulations; the other two models give falsely longer durations of development. When accumulation of temperatures above 30 degrees C becomes substantial, the logistic curve and the Wang model offer more accurate simulations than the day-degree model, which tends to produce shorter durations of development. Further analysis of the data reveals that development rate of this aphid at a given unfavourable high temperature may vary with time. Methods for accurately simulating the development time of L. erysimi in the field are suggested. The significance of modelling insect development at low and high temperatures by non-linear models is discussed.

Animals↗
PubMed2000

Spinal nerve function in five volunteers experiencing transient neurologic symptoms after lidocaine subarachnoid anesthesia.

UNLABELLED: The etiology of transient neurologic symptoms (TNS) after 5% lidocaine spinal anesthesia remains undetermined. Previous case reports have shown that patients acutely experiencing TNS have no abnormalities on neurologic examination or magnetic resonance imaging. The aim of our study was to determine whether volunteers with TNS would exhibit abnormalities in spinal nerve electrophysiology. Twelve volunteers with no history of back pain or neurologic disease underwent baseline electromyography (EMG), nerve conduction studies, and somatosensory-evoked potential (SSEP) testing. Then, the volunteers were administered 50 mg of 5% hyperbaric lidocaine spinal anesthesia and were placed in a low lithotomy position (legs on four pillows). The next day, all volunteers underwent follow-up EMG, nerve conduction, and SSEP testing and were questioned and examined for the presence of complications including TNS (defined as pain or dysthesia in one or both buttocks or legs occurring within 24 h of spinal anesthesia). Volunteers who had TNS underwent additional EMG testing 4-6 wk later. Five of the 12 volunteers reported TNS. No volunteer had an abnormal EMG, nerve conduction study, or SSEP at 24 h follow up, nor were there any changes in EMG studies at delayed testing in the five volunteers experiencing TNS. On statistical analysis, the right peroneal and the right tibial nerve differed significantly for all volunteers from pre- to postspinal testing. When comparing pre- and postspinal testing of the TNS and non-TNS volunteers, statistically significant changes occurred in the nerve conduction tests of the right peroneal and left tibial nerve. There was no difference in measurements of F response, H reflex latency, amplitude, or velocity for either leg. Multivariate analysis of variance showed no significant difference between TNS and non-TNS volunteers for the changes in the nine nerve conduction tests when considered together (P = 0.4). We conclude that acute TNS after lidocaine spinal anesthesia did not result in consistent abnormalities detectable by EMG, nerve conduction studies, or SSEP in five volunteers. IMPLICATIONS: Electrophysiologic testing in volunteers experiencing transient neurologic symptoms is not abnormal.

Adult↗
PubMed2000

A comparison of spinal, epidural, and general anesthesia for outpatient knee arthroscopy.

UNLABELLED: We compared general, epidural, and spinal anesthesia for outpatient knee arthroscopy (excluding anterior cruciate ligament repairs). Forty-eight patients (ASA physical status I-III) were randomized to receive either propofol-nitrous oxide general anesthesia with a laryngeal mask airway with anesthetic depth titrated to a bispectral index level of 40-60, 15-20 mL of 3% 2-chloroprocaine epidural, or 75 mg of subarachnoid procaine with 20 microg fentanyl. All patients were premedicated with <0.035 mg/kg midazolam and <1 microg/kg fentanyl and received intraarticular bupivacaine and 15-30 mg of IV ketorolac during the procedure. Recovery times, operating room turnover times, and patient satisfaction were recorded by an observer using an objective scale for recovery assessment and a verbal rating scale for satisfaction. Statistical analysis was performed with analysis of variance and chi(2). Postanesthesia care unit discharge times for the general and epidural groups were similar (general = 104+/-31 min, epidural = 92+/-18 min), whereas the spinal group had a longer recovery time (146+/-52 min) (P = 0.0003). Patient satisfaction was equally good in all three groups (P = 0.34). Room turnover times did not differ among groups (P = 0.16). There were no anesthetic failures or serious adverse events in any group. Pruritus was more frequent in the spinal group (7 of 16 required treatment) than in the general or epidural groups (no pruritus) (P<0.001). We conclude that epidural anesthesia with 2-chloroprocaine provides comparable recovery and discharge times to general anesthesia provided with propofol and nitrous oxide. Spinal anesthesia with procaine and fentanyl is an effective alternative and is associated with a longer discharge time and increased side effects. IMPLICATIONS: For outpatient knee arthroscopy, anesthesia can be provided adequately with regional or general anesthesia. Epidural and general anesthesia provide equal recovery times and patient satisfaction, whereas spinal anesthesia may prolong recovery and have increased side effects. The choice of anesthesia may depend primarily on the patient's interest in being alert or asleep during the procedure.

Adult↗
PubMed2000

Sedation during spinal anesthesia.

BACKGROUND: Central neuraxial anesthesia has been reported to decrease the dose of both intravenous and inhalational anesthetics needed to reach a defined level of sedation. The mechanism behind this phenomenon is speculated to be decreased afferent stimulation of the reticular activating system. The authors performed a two-part study (nonrandomized pilot study and a subsequent randomized, double-blind, placebo-controlled study) using the Bispectral Index (BIS) monitor to quantify the degree of sedation in unmedicated volunteers undergoing spinal anesthesia. METHODS: Twelve volunteers underwent BIS monitoring and observer sedation scoring (Observer's Assessment of Alertness/Sedation Scale [OAA/S]) before and after spinal anesthesia with 50 mg hyperbaric lidocaine, 5%. Subsequently, 16 volunteers blinded to the study were randomized to receive spinal anesthesia with 50 mg hyperbaric lidocaine, 5% (n = 10) or placebo (n = 6) and underwent BIS and OAA/S monitoring. RESULTS: In part I, significant changes in BIS scores of the volunteers occurred progressively (P = 0.003). The greatest variations from baseline BIS measurement occurred at 30 and 70 min. In part II, there were significant decreases in OAA/S and self-sedation scores for patients receiving spinal anesthesia versuscontrol patients (P = 0.04 and 0. 01, respectively). The greatest decrease in OAA/S scores occurred at 60 min. BIS scores were similar between groups (P = 0.4). CONCLUSIONS: Spinal anesthesia is accompanied by significant sedation progressively when compared with controls as measured by OAA/S and self-sedation scores. This effect was not related to block height. The late sedation observed by OAA/S at 60 min may indicate a second mechanism of sedation, such as delayed rostral spread of local anesthetics. BIS was not a sensitive measure of the sedation associated with spinal anesthesia in the randomized, blinded portion of this study.

Adult↗
PubMed2000

Consumers' perceptions of health care: the case of Hong Kong.

The health care industry in Hong Kong has undergone major changes in organization as well as philosophy of operation since the 1970s. During this period, the Hong Kong government has also experienced a political transition from colonial status to a special administrative region of Mainland China. Because of the economic downturn in East Asia, including Hong Kong, contraction of public spending has compelled the government to reconsider the alternatives for health care provision in Hong Kong. A number of multinational health care providers have entered this market and operate mainly in the private sector, including solely-owned clinics and alliances with existing hospitals. This paper provides an understanding of the evolution and development of the health care industry in Hong Kong and, on that basis, suggests elements of quality health care from the findings of a survey of patients.

Consumer Behavior↗
PubMed2000

Effect of hypertension on the development of diabetic cardiomyopathy.

The effect of hypertension on the progression of diabetic cardiomyopathy was examined by attempting to induce a similar level of diabetes in both spontaneously hypertensive rats (SHR) and Wistar rats. Streptozotocin (STZ) was injected into SHR (45 mg/kg) and Wistar rats (55 mg/kg) before (eight weeks of age) and after (twelve weeks of age) the development of hypertension in the SHR. For both groups of animals, induction of diabetes resulted in depressed weight gain, increased food and fluid consumption, hypoinsulinemia, hyperglycemia, and hypertriglyceridemia. For the rats injected at eight weeks of age, an oral glucose tolerance test (OGTT) demonstrated that although the SHR were significantly less diabetic than Wistar rats, the degree of cardiac dysfunction was equivalent in both strains. These results suggest that hypertension was interacting with the diabetic condition to impair cardiac performance. Injecting SHR at twelve weeks of age increased the severity of diabetes but interestingly did not depress heart function compared with the non-diabetic SHR group. Injecting Wistar rats at this age also increased the severity of diabetes, but unlike the SHR diabetic animals, these rats still had impaired cardiac performance. These results suggest that hypertension exacerbates the cardiac dysfunction seen during diabetes, especially when SHR rats are injected with STZ prior to the elevation of blood pressure. Moreover, in the SHR, the development of LV hypertrophy at the time of STZ injection may have compensated for the damaging effects of diabetes on the myocardium, thereby enabling the heart to perform normally.

Age Factors↗
PubMed2000

Rapid assay of A1c-type glycosylated hemoglobin in blood of diabetic rats using fast protein liquid chromatography.

AIM: To develop a fast protein liquid chromatography (FPLC) method for the assay of Alc-type glycosylated hemoglobin in diabetic rats. METHODS: Venous blood was collected from rats. After the erythrocytes were washed and sedimented, the hemolysate was prepared and diluted with isotonic saline as a sample for the assay. Samples were then separated on Mono_S_HR_5/5 cation exchange column by a lithium chloride gradient elution system. The Alc-type glycosylated hemoglobin was monitored by measuring the absorbance at 415 nm. RESULTS: The Alc-type glycosylated hemoglobin was well separated from total hemoglobin. The average HbAlc amount in diabetic rats was determined to be (3.6% +/- 0.6%, n = 7), while the corresponding figure in normal rats was (1.4% +/- 0.4%, n = 7, P < 0.01). CONCLUSION: This FPLC method is easy, rapid and reproducible, and can be used for an assay of diabetic rat HbAlc to evaluate and screen new drugs for diabetes mellitus therapy.

Animals↗
PubMed1999

Clinical significance of telomerase activation and telomeric restriction fragment (TRF) in cervical cancer.

Telomerase activation was examined in 50 cases of cervical cancer, 27 normal cervix and five cervical cancer cell lines using the sensitive polymerase chain reaction (PCR)-based TRAP (telomeric repeat amplification protocol) assay. Telomeric restriction fragment (TRF) length of these specimens was measured by Southern hybridisation. Telomerase activation was common in cervical cancers and was detected in 46/50 cases (92%). Telomerase activity was weak in normal cervix and was detected only in 2/27 cases (7.4%). Telomerase activity was detected in all stages of cervical cancer suggesting that it is an early event in cancer progression. The clinical significance of telomerase activation was analysed in 47 squamous cell carcinoma of the cervix. High telomerase activity was more frequently detected in advanced diseases (100% in stage III and stage IV cervical cancers combined) compared with early diseases (68.6% in stage I and stage II cancers combined). The difference was statistically significant (P < 0.02). Telomerase activity was not statistically correlated with other clinical parameters examined. This is the first report of telomeric length in human cervical cancer. Both shortening and elongation of TRF length in cervical cancers was observed. Advanced cervical cancers tended to have a wider range of variation of TRF length compared with early disease and normal cervix. There was no obvious relationship between TRF length and the clinical parameters examined including clinical staging, differentiation status of tumour, human papilloma virus (HPV) infection, recurrence rate, tumour size and invasion depth. The clinical significance of TRF length appears to be limited in cervical cancers. Our results indicate that telomerase activity is closely associated with tumour cells and may be useful as a marker for detection of tumour cells in cervical biopsies.

Adenocarcinoma↗
PubMed1999

Abnormal expression or mutation of TP53 and HPV in vulvar cancer.

HPV (human papillomavirus) plays an important role in cervical cancer and may also play a role in vulvar cancer. TP53 mutation is common in a variety of cancers but its role in vulvar cancer is not well established. The aim of this study was to assess the prevalence of HPV infection and TP53 mutation as well as their correlation in vulvar cancer. Also, HPV detection and abnormal p53 expression were assessed in relation to age, co-existing vulvar intraepithelial neoplasia and vulvar dystrophy. Forty-eight samples of vulvar cancer were studied. DNA was extracted from formalin-fixed paraffin embedded tissue for polymerase chain reaction/Southern blot study with HPV 16 and 18 and L1 primers. Paraffin sections were immunostained (IHS) for p53 protein using three antibodies, p1801, CM1 and DO7. The p53 mutation was also screened using polymerase chain reaction (PCR) single-stranded conformation polymorphism (SSCP) and confirmed by sequencing. Overall, HPV was detected in 48% (23/48), of which 96% (22/23) were HPV 16 or 18. By IHS, p53 overexpression was detected in 46% of cases whilst TP53 mutations were identified in 21%. In HPV positive and negative tumours, p53 abnormal expression was detected in 39% and 52%, respectively, and TP53 mutation was found in 22% and 20%, respectively. Mutations were mainly found at codons 273 and 204. Age was not found to be associated with HPV detection. However, the presence of HPV (71%) or absence of abnormal p53 expression (65%) were higher in tumours with VIN3, but were not correlated with dystrophy.

Aged↗
PubMed1999

Proto-oncogenes and p53 protein expression in normal cervical stratified squamous epithelium and cervical intra-epithelial neoplasia.

The aim of this study was to study the protein expression of six proto-oncogenes (epidermal growth factor receptor (EGFR), c-fms, c-myc, c-kit, c-erbB-2 and pan-ras) and one tumour suppressor gene (TP53), by immunohistochemical staining of normal cervical stratified squamous epithelium and cervical intra-epithelial neoplasia (CIN). Paraffin sections of 45 normal cervical specimens, 38 CIN grade one (CIN1), 37 CIN2 and 43 CIN3 were studied. An immunohistochemical (IHC) score was derived from the intensity of staining and the percentages of cells stained. In normal cervical specimens, a higher IHC score was found with EGFR and c-fms in superficial (S), intermediate (I) and parabasal (PB) cells compared with basal cells. In contrast, a higher IHC score was found with c-erbB-2 in basal cells in normal cervical specimens. Dysplastic cells in CIN had a higher IHC score with c-myc and c-erbB-2 than normal S/I and PB cells. Dysplastic cells had a higher score with EGFR than normal basal cells. However, a higher IHC score with EGFR and c-fms was found in normal S/I cells than dysplastic cells. These findings suggested that EGFR and c-fms were activated in more differentiated normal cells but were less active in less differentiated normal basal cells. However, EGFR was reactivated in dysplastic cells. Meanwhile, c-erbB-2 was activated in less differentiated normal basal cells and dysplastic cells, and was less active in differentiated normal cells. c-myc was activated in dysplastic cells. c-fms was more active in more differentiated normal cells and was not activated in less differentiated or dysplastic cells. c-kit, pan-ras and TP53 were not activated in normal nor dysplastic cervical cells. These results suggest EGFR, c-erbB-2 and c-myc may be important proto-oncogenes in CIN and that antibodies or anti-genes targeted against them may alter the progress of CIN to invasive cancer.

Female↗