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目的探讨抑癌基因PTEN及错配修复基因hMLH1在子宫内膜癌(UEC)中的表达及其与子宫内膜癌的临床病理学参数的关系。方法于2002-2004年采用免疫组化SP法,检测36例散发性子宫内膜癌、22例子宫内膜不典型增生(AH)、23例正常子宫内膜(NE)组织中PTEN及hMLH1的表达。结果(1)hMLH1基因在NE、AH和UEC中的表达分别为83%(19/23)、64%(14/22)和11%(4/36),AH及NE的表达与其在UEC中的表达差异有显著性(P<0·01),而前两者比较差异无显著性(P>0.05)。(2)hMLH1基因表达UEC的淋巴结转移、肌层浸润、手术分期、病理类型差异无显著性(P>0·05),与子宫内膜癌病理分化程度有关(P<0·01)。(3)PTEN基因在NE、AH和UEC中的表达分别为100%(23/23)、73%(16/22)和56%(20/36),在AH、UEC中的表达与其在NE中的表达差异有显著性,而前两者比较差异无显著性(P>0.05)。(4)PTEN基因表达与子宫内膜癌的分化程度、淋巴结转移、手术分期、病理类型、肌层是否浸润无统计学相关(P>0.05)。(5)PTEN及hMLH1两种基因蛋白在子宫内膜癌变过程中的表达有相关性(相关系数r=0·28;P<0·05)。结论(1)hMLH1及PTEN均是子宫内膜的保护性基因,在子宫内膜的癌变过程中表达逐渐减少,可能与早期子宫内膜癌癌变的启动有关,且二者有显著的相关性。(2)免疫组化法测定PTEN的表达有可能成为筛选子宫内膜癌变的早期指标。(3)测定hMLH1的表达有可能成为预测子宫内膜癌预后的指标。
Objective To investigate the expression of tumor suppressor gene PTEN and mismatch repair gene hMLH1 in endometrial carcinoma (UEC) and its relationship with the clinicopathological parameters of endometrial carcinoma. Methods Immunohistochemical SP method was used to detect the expression of PTEN and hMLH1 in 36 cases of sporadic endometrial carcinoma, 22 cases of endometrial dysplasia (AH) and 23 cases of normal endometrium (NE) from 2002 to 2004. expression. Results (1) The expression of hMLH1 gene in NE, AH and UEC were 83% (19/23), 64% (14/22) and 11% (4/36), respectively. (P <0.01), while there was no significant difference between the former two groups (P> 0.05). (2) The expression of hMLH1 gene in UEC had no significant difference in lymph node metastasis, myometrial invasion, operation stage and pathological type (P> 0.05), which was associated with the degree of pathological differentiation of endometrial carcinoma (P <0.01). (3) The expression of PTEN gene in NE, AH and UEC were 100% (23/23), 73% (16/22) and 56% (20/36), respectively. In the expression difference was significant, while the former two was no significant difference (P> 0.05). (4) There was no significant correlation between the expression of PTEN gene and the differentiation of endometrial carcinoma, lymph node metastasis, staging, pathological type and infiltration of myometrium (P> 0.05). (5) There was a correlation between PTEN and hMLH1protein expression in endometrial carcinogenesis (correlation coefficient r = 0.28; P <0.05). Conclusions (1) Both hMLH1 and PTEN are protective genes of endometrium, and they are gradually decreased in the process of carcinogenesis of endometrium, which may be related to the initiation of carcinogenesis of early endometrial cancer, and there is a significant correlation between them. (2) Immunohistochemical determination of PTEN expression may be an early indicator of screening for endometrial cancer. (3) Determination of hMLH1 expression may be predictive of prognosis of endometrial cancer indicators.