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目的探讨子宫内膜样腺癌组织中转录因子Snail、上皮钙黏附素(E-cadherin)和基质金属蛋白酶2(MMP-2)的表达关系,研究Snail促进子宫内膜癌侵袭转移的机制及临床意义。方法采用免疫组化方法,结合组织芯片技术,检测58例Ⅰ型子宫内膜癌、17例内膜不典型增生、21例正常内膜组织中Snail、E-cadherin和MMP-2的表达水平,分析3种蛋白表达之间的相关性及与临床病理因素的关系。结果Ⅰ型子宫内膜癌组织中存在Snail和MMP-2蛋白的过度表达以及E-cadherin蛋白的低度表达(P<0.01)。Snail蛋白表达与FIGO分期、淋巴结转移相关(P<0.05),E-cadherin表达的降低与肿瘤肌层浸润和淋巴结转移相关(P<0.05),MMP-2蛋白表达与肿瘤淋巴结转移显著相关(P<0.01)。子宫内膜样腺癌组织中Snail和E-cadherin的表达存在负相关关系(r=-0.259,P<0.05),而Snail蛋白与MMP-2的表达呈显著正相关(r=0.447,P<0.01)。结论 Snail可能通过调节E-cadherin和MMP-2蛋白的异常表达促进子宫内膜样腺癌的侵袭转移,联合检测Snail、E-cadherin和MMP-2对于判断子宫内膜样腺癌的恶性潜能和生物学行为具有重要意义。
Objective To investigate the expression of Snail, E-cadherin and MMP-2 in endometrial adenocarcinoma and to investigate the mechanism and clinical significance of Snail in promoting the invasion and metastasis of endometrial carcinoma significance. Methods The expressions of Snail, E-cadherin and MMP-2 in 58 cases of type Ⅰ endometrial carcinoma, 17 cases of endometrial dysplasia and 21 cases of normal endometrium were detected by immunohistochemistry and tissue microarray. To analyze the correlation between the expression of three proteins and their relationship with clinicopathological factors. Results The overexpression of Snail and MMP-2 protein and the low expression of E-cadherin protein in type Ⅰ endometrial carcinoma (P <0.01). The expression of Snail protein was correlated with FIGO staging and lymph node metastasis (P <0.05), while the decrease of E-cadherin expression was correlated with tumor myometrial invasion and lymph node metastasis (P <0.05). The expression of MMP-2 protein was significantly correlated with lymph node metastasis <0.01). There was a negative correlation between the expression of Snail and E-cadherin in endometrioid adenocarcinoma (r = -0.259, P <0.05), but there was a significant positive correlation between the expression of Snail and MMP-2 (r = 0.447, P < 0.01). Conclusion Snail may promote the invasion and metastasis of endometrial adenocarcinoma by regulating the abnormal expression of E-cadherin and MMP-2 protein. To detect the malignant potential of Snail, E-cadherin and MMP-2 in judging endometrial adenocarcinoma, Biological behavior is of great importance.