目的 探讨子宫内膜癌中雌激素受体(ER)、孕激素受体(PR)、Ki-67和p53的表达及其临床意义.方法 应用免疫组织化学SP法检测20例正常子宫内膜、20例子宫内膜非典型增生及66例子宫内膜癌的ER、PR、Ki-67和p53的表达,分析其表达及与临床分期、组织学分级、肿瘤肌层浸润和淋巴结转的相关性.结果 p53和Ki-67表达阳性率在正常内膜、子宫内膜非典型增生到内膜癌的表达逐渐升高(χ2值分别为16.23、16.23;7.10、5.01,均P<0.05),而ER、PR表达相反,但差异亦均有统计学意义(χ2值分别为18.76、9.69;16.23、10.40,均P<0.05).p53随组织学分级、肌层浸润、淋巴结转移的增高而升高,差异均有统计学意义(均P<0.01),与临床分期无关(P>0.05);Ki-67与淋巴结转移有关(P<0.01),与临床分期、组织学分级及肌层浸润无关(均P>0.05).结论 ER、PR、p53和Ki-67与子宫内膜癌的发生、发展、转移及预后相关.%Objective To investigate the expression and clinical significance of estrogen receptor ( ER ), progesterone receptor ( PR ), Ki-67 and p53 in endometrial carcinoma. Methods Immunohistochemical SP assay was used to detect the expressions of ER, PR, Ki-67 and p53 in 20 cases of normal endometria, 20 cases of atypical hyperplasia and 66 cases of endometrial carcinoma, and the correlation between their expressions and clinical staging, histological grade, tumor invasion and lymph node metastases was analyzed. Results The positive expression rate of p53 and Ki-67 in normal endometrial tissue, atypical hyperplasia and endometrial carcinoma increased gradually ( χ2 value was 16. 23 and 16. 23 , 7. 10 and 5. 01, respectively, all P <0.05 ),but the positive expression rate of ER and PR was opposite, and the differences were significant (χ2 value was 18. 76 and 9. 69, 16. 23 and 10. 40, respectively, all P < 0. 05 ). With the increasing of histological grade, the depth of myometrial invasion and lymph node metastasis, the expression of p53 increased, and the difference was significant ( P <0. 01 ). But the expression was not related with clinical stage ( P > 0. 05 ). The expression of Ki-67 was significantly related with metastasis ( P <0. 01 ), but it was not related with clinical stage, histological grade and the depth of myometrial invasion ( all P>0. 05 ). Conclusion The expressions of ER, PR, Ki-67 and p53 are correlated with the occurrence, development, metastasis and prognosis of endometrial carcinoma.
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