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目的:探讨卵巢浆液性癌(ovarian serous carcinoma,OSC)人端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)和p16的表达及意义。方法:收集南京军区南京总医院病理科1997-10-29-2010-11-03(79例)和南京市妇幼保健院病理科2006-04-21-2012-02-02(29例)共108例OSC,另选取南京市妇幼保健院2005-12-05-2013-01-23(29例)和南京军区南京总医院2002-06-04-2013-02-04(12例)共41例卵巢浆液性交界性肿瘤(serous borderline tumor,SBT)作为对照,其中经典型28例,微乳头型13例。采用免疫组化EnVision法检测hTERT和p16的表达,分析其与OSC临床病理参数的关系。结果:hTERT在OSC(86.11%)和SBT(78.05%)中阳性率差异有统计学意义,P=0.048;hTERT表达与复发(P=0.022)、FIGO分期(P=0.003)和MDACC分级(P=0.016)有关。OSC中p16阳性率为89.81%,p16表达与年龄(P=0.038)、淋巴结转移(P=0.002)、复发(P=0.002)、FIGO分期(P=0.001)和MDACC分级(P=0.001)有关。p16在经典型SBT(60.71%)、微乳头型SBT(30.77%)、低级别浆液性癌(13.64%)中阳性率组间差异有统计学意义,P=0.003。结论:hTERT高表达促进卵巢浆液性肿瘤病变进展并提示预后差,能辅助鉴别诊断高、低级别浆液性癌。p16基因失活促进卵巢低级别浆液性肿瘤进展,而p16高表达提示为高级别的晚期OSC,预后较差。
Objective: To investigate the expression and significance of human telomerase reverse transcriptase (hTERT) and p16 in ovarian serous carcinoma (OSC). METHODS: The pathology of Nanjing General Hospital of Nanjing Military Region was collected from October 1997 to October 29,2010-11-03 (79 cases) and Nanjing MCH Hospital of Pathology 2006-04-21-2012-02-02 (29 cases) Cases of OSC, the other selected Nanjing Maternal and Child Health Hospital 2005-12-05-2013-01-23 (29 cases) and the Nanjing Military Region Nanjing General Hospital 2002-06-04-2013-02-04 (12 cases), a total of 41 cases of ovarian Serous borderline tumor (SBT) served as a control, including 28 cases of classical type and 13 cases of micro-papillary type. Immunohistochemical EnVision method was used to detect the expression of hTERT and p16, and its relationship with clinicopathological parameters of OSC. Results: The positive rates of hTERT in OSC (86.11%) and SBT (78.05%) were significantly different (P = 0.048), hTERT expression and recurrence (P = 0.022), FIGO stage = 0.016). The positive rate of p16 in OSC was 89.81%. The expression of p16 was related to age (P = 0.038), lymph node metastasis (P = 0.002), recurrence (P = 0.002), FIGO stage (P = 0.001) and MDACC grade . The positive rate of p16 in the group of SBT (60.71%), micro-papillary SBT (30.77%) and low-grade serous carcinoma (13.64%) was statistically significant, P = 0.003. Conclusion: The high expression of hTERT promotes the progression of ovarian serous tumors and suggests poor prognosis, which can be used to differentiate the diagnosis of high and low grade serous carcinoma. The inactivation of p16 gene promotes the progression of ovarian low-grade serous tumors, while the high expression of p16 suggests a high grade of advanced OSC with poor prognosis.