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目的探讨转化生长因子β1(TGFβ1)及TGFβⅡ型受体(TGFβRⅡ)在子宫内膜增生症、子宫内膜样腺癌组织中的表达及其与临床病理的关系。方法子宫内膜蜡块标本241例分为4组:单纯性增生(A)组58例,复杂性增生(B)组45例,不典型增生(C)组36例,子宫内膜样腺癌(D)组60例;另取正常增生期子宫内膜42例为对照(E)组。应用免疫组织化学SP法检测TGFβ1及TGFβRⅡ在内膜组织中的表达。结果(1)D组TGFβ1阳性率高于E组、A组和B组(P<0.05);D组中TGFβ1阳性率随肌层浸润深度的增加而升高(P<0.05),但在不同临床分期、不同病理分级、有无淋巴结转移中其表达差异无统计学意义(P>0.05)。(2)E组TGFβRⅡ阳性率高于B组、C组和D组(P<0.05);TGFβRⅡ的阳性表达率随着肌层浸润深度的增加或病理分级的降低逐渐下降(P<0.05);但有无淋巴结转移中其阳性表达率无明显差异(P>0.05)。结论TGFβ1及TGFβRⅡ在子宫内膜增生、癌变的过程中发挥作用,与子宫内膜样腺癌发生、发展有关。
Objective To investigate the expression of transforming growth factor β1 (TGFβ1) and TGFβ receptor Ⅱ (TGFβRⅡ) in endometrial hyperplasia and endometrioid adenocarcinoma and its relationship with clinicopathological features. Methods 241 cases of endometrial wax specimens were divided into 4 groups: 58 cases in simple hyperplasia (A) group, 45 cases in complicated hyperplasia (B) group, 36 cases in atypical hyperplasia (C) group and endometrial adenocarcinoma (D) group of 60 cases; another normal proliferative endometrium in 42 cases as a control group (E). Immunohistochemical SP method was used to detect the expression of TGFβ1 and TGFβRII in intima. Results (1) The positive rate of TGFβ1 in group D was higher than that in group E, group A and group B (P <0.05). The positive rate of TGFβ1 in group D was increased with the depth of myometrial invasion (P <0.05) There was no significant difference in clinical stage, different pathological grade and lymph node metastasis (P> 0.05). (2) The positive rate of TGFβR Ⅱ in group E was higher than that in group B, C and D (P <0.05). The positive rate of TGFβR Ⅱ decreased gradually with the depth of myometrial invasion or the pathological grade decreased (P <0.05). However, there was no significant difference in the positive rate of lymph node metastasis (P> 0.05). Conclusion TGFβ1 and TGFβRⅡ play a role in the process of endometrial hyperplasia and carcinogenesis, which is related to the occurrence and development of endometrial adenocarcinoma.