p53、Ki67和CA125表达在宫颈微偏腺癌与普通宫颈腺癌鉴别中的价值

摘要

目的：：探讨不同肿瘤标记物的表达在宫颈微偏腺癌( minimal deviation adenocarcinoma,MDA)与普通宫颈腺癌( adenocarcinoma of the uterine cervix,AUC)鉴别诊断中的意义。方法：收集2001年7月至2013年6月间于中国医科大学附属盛京医院、沈阳市妇婴医院、辽宁省肿瘤医院妇科病房进行手术治疗的19例MDA、同期的50例普通AUC(分化程度：高分化16例,中分化20例,低分化14例)病理标本,采用免疫组化的方法检测Ki67、SMA、p53、PCNA、Vimentin、CEA、ER、CA125和PR的表达。结果：MDA中p53和大于50%细胞核染Ki67(Ki67/50+)的阳性率分别是84%和68%,明显高于普通AUC(分别是38%和18%,P<0.01),MDA中CA 125的阳性率为21%,明显低于普通AUC中的58%(P<0.01)。 CEA、PR、Vimentin、ER、PCNA和SMA在两组比较中没有差异(P>0.05)。所有标记物的表达在普通AUC的高、中、低分化组别中没有明显差异(P>0.05)。结论：p53和Ki67/50+的阳性表达及CA125的阴性表达有助于MDA与普通AUC的鉴别,从而有利于MDA的早期诊断及治疗。%Objective:To investigate the significance of the expression of different tumor markers in differential di-agnosis between minimal deviation adenocarcinoma ( MDA ) and common adenocarcinoma of the uterine cervix (AUC). Methods:The expressions of Ki67,SMA,p53,PCNA,Vimentin,CEA,ER,CA125 and PR were detected by an immunohistochemical method in cervical tissues from 19 cases of MDA and 50 cases of AUC ( differentiation rank:high 16,moderate 20,low 14) in Shengjing Hospital of China Medical University,Shenyang Woman and Children Hospital and Liaoning Cancer Hospital and Institute from July 2001 to June 2013. Results:The positive immunostain-ing rates for p53 and Ki67 in>50% of the cell nuclei ( Ki67/50+) were 84% and 68% in MDA respectively,signifi-cantly higher than common AUC (38%,18%,P<0. 01). CA125 was 21% in MDA,being clearly lower than common AUC(58%,P<0. 01). There was no difference between MDA and common AUC for CEA,PR,Vimentin,ER,PCNA and SMA (P>0. 05). No significant difference was noticed among the high,moderate and low differentiation groups in common AUC (P>0. 05). Conclusion:Positive immunohistochemical staining for p53,Ki67/50+ and negative for CA125 can assist differential diagnosis for MDA from common AUC, thus to improve the early stage diagnosis and treatment for MDA.