본 연구는 면역조직 화학적 검사법을 이용하여 자궁경부 전암 병변 및 자궁경부암 조직에서 p53과 pRB 단백의 발현을 조사하여 다음과 같은 결과를 얻었다. 1. 대조군과 CIN Ⅰ 조직의 p53 단백의 발현은 관찰되 지 않았으며, RB 단백 발현은 basal layer와 parabasal layer내의 소수의 세포에서 관찰되었다. 2. p53 단백의 과발현은 CIN Ⅲ 21예 중 3예(14.3%)에 서, 자궁경부암 37예 중 22예(59.5%)에서 관찰되었고, RB 단백 발현의 소실은 CIN Ⅲ 21예 중 5예(23.8%)에서, 자궁경부암 37예 중 4예(10.8%)에서 관찰되었다. 3. 임상 병기에 따른 p53 단백의 면역 반응도(Immu noreactivity)는 임상 병기가 진행될수록 의의있는 증가를 나타냈으나(p＜0.05), RB 단백 발현의 소실은 임상 병기 와의 연관성을 나타내지 않았다. 4. 자궁경부암의 조직학적 유형에 따른 p53 단백의 면 역 반응도(Immoreactivity)는 편평 세포암(Squamous cell carcinoma)인 경우, 다른 유형에 비하여 의의있게 증가되 었으나(p＜0.05), RB 단백의 경우 조직학적 유형과의 연 관성을 관찰할 수 없었다(p＞0.05). 결과적으로 RB 유전자 기능의 소실은 자궁경부암보 다는 CIN Ⅲ에서 더 많이 관찰되어 자궁경부암 발암 과 정의 초기에 관여하고, p53 유전자 기능의 소실은 자궁 경부암 발암 과정의 후기에 관여하리라 생각되나, 향후 HPV와의 연관성 및 추적 관찰이 필요하리라 사료된다.

Carcinoma of the uterine cervix is the most common malignant tumor in Korean women. It is well known that carcinogenesis is a multi-step event involoving the inactivation of tumor supressor genes, such as p53 gene and RB gene. The inactivation of the normal functions of the tumor-suppressor proteins pRB and p53 are important steps in human cervical carcinogenesis, either by mutation or from complex formation with the HPV E6 and E7 oncoproteins. The pRB protein regulates early cell cyle progression by controlling transit through the G1 phase of the cell cyle. The p53 tumor suppressor gene product also plays a role in cell cycle control by the transcriptional regulation of cyclin-CDK inhibitor. Cervical carcinoma is an excellent model for studying the stepwise progression of cell transformation because this is reflected morphologically by the increasing dysplasia of the squamous cells before it becomes and invasive squamous cell carcinoma. The aim of this study was to examine the expression of pRB and compared that with overexpression of p53 in a series of cervical lesions including normal tissuess, dysplasias, carcinoma in situ and carcinomas by immunohistochemical staining with monoclonal antibody to elucidate the role of these tumor suppressor genes. The result were as follows: 1. In normal cervical mucosa and CIN Ⅰ, a few positively stained cells for pRB were seen in basal and parabasal layer. 2. An abnormality of pRB, loss of expression was seen in 23.8% of CIN Ⅲ and in 10.8% of invasive carcinoma. 3. Overexpression of p53 was demonstrated in 14.3% of CIN Ⅲ and in 59.5% of invasive carcinoma. 4. The immunoreactivity of p53 was significantly increased (p＜0.05) in stage Ⅱ, Ⅲ than stage Ⅰ, whereas downregulation of pRB and tumor stage was not correlated. 5. The immunoreactivity of p53 was significantly increased (p＜0.05) in squamous cell carcinoma than in adenocarcinoma, adenosquamous carcinoma and CIN Ⅲ. These result suggest that an alteration of pRB is more frequently implicated in CIN Ⅲ than invasive carcinoma, whereas overexpression of p53 may be involevd in late progression of uterine cervical carcinoma.