子宫内膜癌标志物表达及其临床意义研究

摘要

Objective To study the relationship between the expression of p53,PTEN,p16,HER-2 and Ki67 and the occurrence and development of endometrial carcinoma.Methods The expression of p53,PTEN,pl6,HER-2 and Ki67 was determined in 50 cases of normal endometrial tissues,20 atypical endometrial hyperplasia and 75 endometrial carcinoma using immunohistochemistry.Results The positive expression rates of p53,PTEN,p16,HER-2 and Ki67 in normal endometrial tissues and endometrial carcinomas were significantly different (P ＜ 0.05).The expressions of HER-2 and Ki67 in atypical endometrial hyperplasia were significantly higher than those in normal endometrial tissues (P ＜0.05),and the expressions of PTEN and Ki67 in endometrial carcinomas and endometrial atypical hyperplasia were significantly different (P ＜ 0.05).The expressions of p53,PTEN,p16 and HER-2 in type Ⅰ and 11 carcinomas were significantly different (P＜0.05),but the expression of Ki67 were similar (P＞0.05).The expression of p53 was significantly related to histological grade,the depth of myometrial invasion,lymph node metastasis and clinical stage (P ＜0.05).The expressions of PTEN,p16,HER-2 and Ki67 were not related to those clinical pathological features.Conclusion The expression of p53,PTEN,p16,HER-2 and Ki67 is closely related to the occurrence and development of endometrial carcinoma.These markers can be used in the pathological diagnosis of endometrial diseases in the clinical practice work.%目的 探讨p53、磷酸酶与张力蛋白同源物(PTEN)、p16、人类表皮生长因子受体-2(HER-2)、Ki67的表达及其与子宫内膜癌发生发展的相关性.方法 采用免疫组织化学法检测上海市普陀区妇婴保健院病理科2009月1年至2015年12月确诊的50例正常子宫内膜组织、20例不典型增生子宫内膜组织及75例子宫内膜癌中p53、PTEN、p16、HER-2及Ki67的表达,并对不同子宫内膜组织的表达结果进行比较.结果 p53、PTEN、p16、HER-2和Ki67在正常子宫内膜和子宫内膜癌中的表达差异均有统计学意义(P＜ 0.05),在不典型增生子宫内膜中HER-2和Ki67表达显著高于正常子宫内膜(P＜0.05),子宫内膜癌与不典型增生子宫内膜中PTEN、Ki67的表达差异有统计学意义(P＜0.05).在Ⅰ型和Ⅱ型子宫内膜癌之间p53、PTEN、p16、HER-2表达差异有统计学意义(P＜0.05),Ki67在Ⅰ型和Ⅱ型子宫内膜癌间表达相近(P＞0.05).p53在子宫内膜癌的表达率与肿瘤的分化程度、浸润深度、脉管情况及临床分期密切相关(P＜0.05),而PTEN、p16、HER-2和Ki67的表达与这些临床病理特征无关(P＞ 0.05).结论 p53、PTEN、p16、HER-2和Ki67蛋白的表达与子宫内膜癌的发生发展相关,在实际临床工作中可用于子宫内膜病变的病理诊断.