PubMed · 11185290
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R Lenardos. 2000. Implementing new technology for Pap testing.. https://pubmed.ncbi.nlm.nih.gov/11185290/
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The physical character and amount of mucus secreted by the endocervix changes dramatically at midcycle to facilitate the reproductive process. Mucins expressed by the endocervical epithelium contribute to this all-important physiologic event. This review summarizes work from our laboratory demonstrating the mucin gene expression profile of cervical epithelium and mucin levels in cervical mucus through the menstrual cycle. mRNA levels of the gel-forming mucin MUC5B, the major gel-forming mucin expressed by the endocervical epithelium, peak before midcycle and the amount of MUC5B protein per unit total protein in cervical mucus peaks at midcycle. Message levels for MUC4, a major membrane-spanning mucin of the endocervix, peak at midcycle, but protein levels of MUC4 in human cervical mucus have not been measured. Message for each mucin diminishes dramatically as progesterone levels increase in the blood. These data suggest hormonal regulation of the two mucin genes in the endocervix, but there is no information on their regulation at the biosynthetic level via genomic hormone response elements. Perhaps, through its hydrophilicity, the MUC5B mucin holds water in place at the endocervical canal surface at midcycle, keeping the canal patent for sperm motility. A second potential role of the increased mucins at midcycle is to protect the cervix and uterus at the time when increased water is secreted into the cervical canal to facilitate sperm penetrance. Pathogens and other seminal fluid components may be excluded from entering the uterus by mucin trapping. Studies to determine the mechanism of hormonal regulation of mucins as well as the function of individual mucins are needed.
Recently putative catalytic telomerase subunit was identified as telomerase reverse transcriptase (TERT). Several reports showed that TERT expression correlated with telomerase activity. It has also been found that c-myc can induce telomerase activation through TERT expression. We examined expression of TERT and c-myc and their correlation in cervical cancers by reverse transcription-polymerase chain reaction (RT-PCR). It was found that TERT and c-myc expression was observed mostly in malignancies and expression of c-myc was concordant for positivity and negativity with TERT. These results support recent studies that c-myc expression is closely associated with TERT and telomerase activity. c-myc up-regulation may play an important role in activation of TERT and telomerase.
Vascular endothelial growth factor-C (VEGF-C) has been implicated in lymphangiogenesis, the process of new lymphatics formation. The present study investigated VEGF-C mRNA expression in invasive cervical cancer tissue. Additionally, the association of VEGF-C mRNA with clinicopathological features was examined. VEGF-C mRNA expression was assessed by reverse transcription-polymerase chain reaction using beta-action as an internal control. 75 patients presenting with invasive cervical cancer were included in the trial. VEGF-C mRNA expression was markedly higher in tumours in which pelvic lymph node metastasis was diagnosed by magnetic resonance (MR) imaging (P = 0.002). 53 patients displaying stage Ib-IIb cervical cancer underwent radical hysterectomy and pelvic lymphadenectomy. VEGF-C expression was significantly higher in tumours exhibiting deep stromal invasion, pelvic lymph node metastasis and lymph-vascular space involvement (P = 0.016, P = 0.006 and P = 0.036, respectively). Multivariate analysis revealed VEGF-C mRNA expression to be the sole independent factor influencing pelvic lymph node metastasis. Subjects demonstrating VEGF-C mRNA expression displayed significantly poorer prognoses than those lacking VEGF-C mRNA expression (P = 0.049). These findings provide evidence supporting the involvement of VEGF-C expression in the promotion of lymph node metastasis in cervical cancer. Furthermore, examination of VEGF-C expression in biopsy specimens may be beneficial in the prediction of pelvic lymph node metastasis.