目的:探讨基因hMSH2与细胞增殖、凋亡在子宫颈腺癌中的意义。方法:采用免疫组化SP法检测hMSH2、Ki67的表达,DNA原位末端标记(TUNEL)检测细胞凋亡。结果:36例宫颈腺癌组织中10例hMSH2呈阴性(28%),26例为阳性表达(72%),且与肿瘤分化程度相关,分化程度越低阳性率越低(P<0.05),hMSH2的表达与肿瘤组织学类型和FIGO分期未见明显关系(P>0.05)。TUNEL阳性指数癌旁正常子宫颈腺上皮均<4%,而子宫颈腺癌均>5%,低分化腺癌明显低于高、中分化腺癌(P<0.05),高、中分化腺癌间差异未达统计学意义(P>0.05),不同组织学类型TUNEL阳性指数相似。Ki-67阳性指数在癌旁正常子宫颈腺上皮均<10%,子宫颈腺癌<10%者仅3例(均为高分化腺癌),>10%者33例;低分化、中分化腺癌的Ki-67阳性指数明显高于高分化腺癌(P<0.01),低分化与中分化腺癌间差异未达统计学意义(P>0.05);Ki-67的表达与子宫颈腺癌组织学类型未见明显关系。hMSH2阴性子宫颈腺癌TUNEL阳性指数显著低于hMSH2阳性者(P<0.05),而Ki-67阳性指数两者差异无统计学意义(P>0.05)。结论:子宫颈腺癌存在基因hMSH2失表达,hMSH2失表达反映了肿瘤的恶性程度,Ki-67、TUNEL阳性指数与子宫颈腺癌分化程度相关,基因hMSH2可能参与细胞凋亡。 Objective: To investigate the significance of gene hMSH2 and cell proliferation and apoptosis in cervical adenocarcinoma. Methods: The expressions of hMSH2 and Ki67 were detected by immunohistochemical SP method. Apoptosis was detected by TUNEL. Results: The positive rate of hMSH2 in 36 cases of cervical adenocarcinoma was 28% and in 26 cases was 72%. The positive rate of hMSH2 was correlated with the degree of differentiation (P <0.05) The expression of hMSH2 had no significant correlation with tumor histological type and FIGO staging (P> 0.05). TUNEL positive index adjacent to the normal uterine gland epithelium were <4%, while the cervical adenocarcinoma were> 5%, poorly differentiated adenocarcinoma was significantly lower than the high, moderately differentiated adenocarcinoma (P <0.05), high and moderately differentiated adenocarcinoma The difference was not statistically significant (P> 0.05), TUNEL positive index of different histological types were similar. Ki-67 positive index in the normal adjacent gland epithelium were <10%, cervical adenocarcinoma <10% were only 3 cases (all well-differentiated adenocarcinoma),> 10% in 33 cases; poorly differentiated, moderately differentiated Ki-67 positive index of adenocarcinoma was significantly higher than that of well-differentiated adenocarcinoma (P <0.01), while there was no significant difference between poorly differentiated and moderately differentiated adenocarcinoma (P> 0.05) There was no obvious relationship between histological types of cancer. The positive rate of TUNEL in hMSH2-negative cervical adenocarcinoma was significantly lower than that in hMSH2-positive (P <0.05), while the positive rate of Ki-67 was not statistically different (P> 0.05). Conclusion: Loss of hMSH2 gene expression in cervical adenocarcinoma, loss of hMSH2 expression reflects the degree of malignancy, Ki-67, TUNEL positive index and cervical adenocarcinoma differentiation related to the gene hMSH2 may be involved in apoptosis.