目的：探讨人组织激肽释放酶4（ KLK4）在子宫内膜癌中的表达和对预后的影响，为改善子宫内膜癌的预后提供新的思路。方法免疫组化法检测81例子宫内膜癌、30例不典型增生的子宫内膜和30例正常子宫内膜中KLK4的表达情况，收集患者临床病理资料，结合随访资料做生存分析，并分析KLK4的表达和子宫内膜癌预后的关系。结果 KLK4在正常内膜、不典型增生内膜和子宫内膜癌中的高表达率分别为30％、53％、67％，差异有统计学意义（χ2＝12．059，P＝0．002）；KLK4的高表达和子宫内膜癌的分化程度及深肌层浸润相关（χ2＝7．985，P＝0．021；χ2＝4．629，P＝0．031），与年龄、临床分期、淋巴结转移无关（χ2值分别为0．266、1．761、0．277，均P＞0．05）；KLK4高表达组的5年无进展生存率较低表达组更低，差异有统计学意义（P＝0．032）。结论 KLK4的高表达可能与子宫内膜癌细胞的分化和局部侵袭有关，其高表达提示早期复发，KLK4有可能作为预测子宫内膜癌早期复发的标志物。%Objective To investigate the expression of human kallikrein 4 ( KLK4 ) in endometrial carcinoma and its influence on prognosis, so as to provide new thoughts for improving prognosis of endometrial carcinoma .Methods Immunohistochemical methods were used to detect the expression of KLK 4 in 81 cases of endometrial carcinoma , 30 cases of atypical endometrial hyperplasia and 30 cases with normal endometrium.Clinicopathological information of cases was collected and survival analysis was analyzed comnbining follow -up data. The relationship between the expression of KLK 4 and prognosis of endometrial carcinoma was analyzed .Results The high expression rate of KLK4 in normal endometrium , atypical endometrial hyperplasia and endometrial carcinoma was 30%, 53% and 67%, respectively , and the difference was significant (χ2 =12.059, P=0.002).High expression of KLK4 was positively correlated with histological grade and deep muscular invasion of endometrial carcinoma (χ2 =7.985,P=0.021;χ2 =4.629,P=0.031), but not correlated with age, clinical stage and lymph node metastasis (χ2 value was 0.266, 1.761 and 0.277, respectively, all P>0.05).Five-year progression-free survival (PFS) rate of the high KLK4 expression group was lower than that of low KLK4 expression group with significant difference (P=0.032). Conclusion High expression of KLK4 in endometrial carcinoma is possibly correlated with differentiation and local invasion of cancer cells . High expression indicates early recurrence .KLK4 may be used as a marker to predict early recurrence of endometrial carcinoma .
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