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目的探讨转移抑制基因KAI1/CD82和雌孕激素受体(ER、PR)在子宫内膜癌组织中的表达及与淋巴结转移的关系,并分析其临床意义。方法应用SP法对76例子宫内膜癌组织中KAI1、PR、ER的蛋白表达情况进行观察。结果子宫内膜癌组织中KAI1和PR的阳性表达与手术病理分期、组织学分级、肌层浸润深度呈负相关(PKAIl=0.0089、0.0103、0.0356,PPR=0.0026、0.000、0.0053);伴有盆腔淋巴结转移、宫旁或附件受累及的组织KAI1、PR、ER的阳性表达均明显低于无转移的组织(PKAIl=0.0091、0.0073,PPR=0.0006、0.0074,PER=0.0129、0.0073);ER的阳性表达与FIGO分期呈负相关(P=0.0226);不同的病理类型中,只有PR表达差异有统计学意义(P=0.0446);而三者的表达与患者年龄及宫颈是否受累均无关。KAI1、PR、ER表达阴性和阳性的生存率差异均有统计学意义(PKAIl=0.0043,PPR=0.0010,PER=0.0124)。Logistic回归模型分析结果提示:KAI1、PR、ER三个变量中只有KAI1与淋巴结转移有关(P=0.0400,OR=0.245)。COX比例风险回归模型分析结果显示:KAI1、PR、ER表达均不是子宫内膜癌的独立预后因素。结论KAI1表达与子宫内膜癌的淋巴结转移具有相关性,其可作为临床预测子宫内膜癌患者发生淋巴结转移和评估预后的综合指标之一。KAI1在子宫内膜癌发展中所起的作用可能与PR有关,KAI1、PR、ER的缺失表达与子宫内膜癌的发展、治疗及预后密切相关。
Objective To investigate the expression of metastasis suppressor gene KAI1 / CD82 and estrogen and progesterone receptor (ER, PR) in endometrial carcinoma and its relationship with lymph node metastasis and to analyze its clinical significance. Methods The protein expression of KAI1, PR and ER in 76 cases of endometrial carcinoma was observed by SP method. Results The positive expressions of KAI1 and PR in endometrial carcinoma were negatively correlated with the pathological stage, histological grade and the depth of myometrial invasion (PKAIl = 0.0089,0.0103,0.0356, PPR = 0.0026,0.000,0.0053) The positive expression of KAI1, PR and ER in tissues involved in lymph node metastasis, uterine or appendix were significantly lower than those without metastasis (PKAI1 = 0.0091,0.0073, PPR = 0.0006,0.0074, PER = 0.0129,0.0073) (P = 0.0226). Among the different pathological types, only the expression of PR was statistically different (P = 0.0446). The expression of the three was not related to the age and cervical involvement. There were significant differences in the survival rates of KAI1, PR and ER negative and positive patients (PKAI1 = 0.0043, PPR = 0.0010, PER = 0.0124). Logistic regression analysis showed that only KAI1 was associated with lymph node metastasis (P = 0.0400, OR = 0.245) among the three KAI1, PR and ER variables. COX proportional hazards regression model analysis showed that: KAI1, PR, ER expression is not an independent prognostic factor for endometrial cancer. Conclusion The expression of KAI1 is correlated with the lymph node metastasis of endometrial carcinoma, which may be used as one of the comprehensive indexes to predict the occurrence of lymph node metastasis and prognosis in patients with endometrial cancer. The role of KAI1 in the development of endometrial cancer may be related to PR. The deletion expression of KAI1, PR and ER is closely related to the development, treatment and prognosis of endometrial cancer.