摘要
目的:探讨子宫内膜癌中雌激素受体(estrogen receptor,ER)、孕激素受体(progestin receptor,PR)、第10染色体同源缺失性磷酸酶-张力蛋白基因(phosphatase and tension homology deleted on chromosome ten,PTEN)、p53及Ki-67的表达与临床、病理特征及预后的关系。方法:收集200例原发性子宫内膜癌患者的临床信息、组织病理、免疫组织化学结果及随访资料,进行统计学分析。结果:(1)子宫内膜癌病例中ER、PR、PTEN、p53的阳性表达率分别为86.5%、85.5%、82.1%和49.2%;Ki-67在癌灶中的阳性表达率为46.9%±24.7%。(2)妊娠次数与PR阳性表达呈负相关(r=-0.191,P=0.007),而发病年龄、分娩次数与p53阳性表达呈正相关(r=0.184,P=0.041;r=0.255,P=0.004)。(3)子宫内膜样腺癌中ER、PR、p53阳性率与其他类型内膜癌比较差异有统计学意义(P<0.01)。(4)ER阳性表达与手术病理分期呈负相关(r=-0.176,P=0.013),其中Ⅰ期患者的ER阳性率高于Ⅱ期及以上患者(P=0.015)。(5)ER、PR阳性表达与组织学分级呈负相关(r=-0.217,P=0.002;r=-0.317,P=0.000),但p53、Ki-67表达与其呈正相关(r=0.327,P=0.000;r=0.465,P=0.000);组织学Ⅲ级的ER、PR、p53、Ki-67表达与其他级别比较差异有统计学意义(P<0.01)。(6)ER阳性表达与肌层浸润深度呈负相关(r=-0.142,P=0.047),有或无深肌层浸润两者比较,ER、PR表达率差异均有统计学意义(P<0.05)。(7)多因素生存分析显示,PR表达的差异对总生存时间的影响有统计学意义(P=0.011)。结论:术前对诊断性刮宫标本进行免疫组织化学研究有助于全面了解子宫内膜癌的临床病理特征;除PR外,ER、PTEN、p53及Ki-67的表达情况对患者临床预后的预测意义较小。
Objective：To explore the relationships between the expressions of estrogen receptor（ER）,progestin receptor（PR）,phosphatase and tension homology deleted on chromosome ten（PTEN）,p53,Ki-67 and the clinicopathologic features and prognosis in endometrial carcinoma.Methods： The data of clinical characteristics,pathological types,histological grades,follow-ups and the expressions of molecular markers detected by immunohistochemistry,and collected from 200 patients with primary endometrial carcinoma,were analyzed.Results：（1） In the cases of endometrial carcinoma,the expression rates of ER,PR,PTEN,p53 were 86.5%,85.5%,82.1%,and 49.2%,respectively.The expression level of Ki-67 in the tumor tissues was 46.9%±24.7%.（2） A negative correlation was observed between the gravidity and the expression of PR（r=-0.191,P=0.007）.On the other hand,age and parturition time were in positive correlation with the expression of p53（r=0.184,P=0.041;r=0.255,P=0.004）.（3） The expression rates of ER,PR and p53 in the endometrioid carcinoma exhibited significant differences comparing with other types（P0.01）.（4） A negative correlation was found between the expression of ER and the FIGO staging（r=-0.176,P=0.013）.The positive rate of ER in the cases with Stage Ⅰ was higher than that in cases with Stage Ⅱ and above（P=0.015）.（5） A negative correlation was found between the histological grade and the expressions of ER and PR（r=-0.217,P=0.002;r=-0.317,P=0.000）,however,a positive correlation was detected between the grade with the expressions of p53 and Ki-67（r=0.327,P=0.000;r=0.465,P=0.000）.Compared with the grade 3 tumors,the other grades exhibited significant different expression levels of ER,PR,p53,and Ki-67（P0.01）.（6） A negative correlation was observed between the depth of myometrial invasion and the positive rate of ER（r=-0.142,P=0.047）.There were statistically significant different expression rates of ER and PR between the cases whether the cancer invaded the deep myometrium or not（P0.05）.（7） Multivariate survival analysis showed that patients with PR（＋） had longer overall survival than those with PR（-）（P=0.011）.Conclusion： The immunohistochemical study of endometrium samples obtained from dilatation and curettage of uterine will be beneficial to the understanding of the clinicopathologic features of the endometrial carcinoma before the operation.The value of estimating the prognosis using the expressions of ER,PTEN,p53 and Ki-67 was negative,except for the expression of PR.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2011年第5期743-748,共6页
Journal of Peking University:Health Sciences
基金
教育部高等学校博士学科点专项科研基金(20090001110085)资助~~
关键词
子宫内膜肿瘤
受体
雌激素
孕激素类
免疫组织化学
预后
Endometrial neoplasms
Receptors
estrogen
Progestins
Immunohistochemistry
Prognosis
