上皮性卵巢癌组织中Ki67和PCNA的表达及有丝分裂指数  

Expressions of Ki67,PCNA and Mitotic Index in Ovarian Epithelial Tumors

作　　者：王帅[1] 马晓艳[1] 夏阳[2] 张丽红[3] 

机构地区：[1]吉林大学第二医院妇产科,长春130041 [2]吉林大学第二医院病理科,长春130041 [3]吉林大学基础医学院病理解剖学教研室,长春130021

出　　处：《四川大学学报（医学版）》2010年第4期575-580,共6页Journal of Sichuan University(Medical Sciences)

基　　金：吉林省科技厅资助项目(200505140)

摘　　要：目的分析不同的增殖指标与上皮性卵巢癌临床病理指标的相关性,并探讨其对个体化治疗的指导意义。方法应用免疫组织化学二步法检测109例上皮性卵巢癌组织(其中73例有转移灶),20例交界性、28例良性上皮性卵巢瘤及20例正常卵巢上皮组织中Ki67、PCNA的蛋白核表达并观察计算有丝分裂指数(MI);同时应用原位杂交法检测其中74例卵巢上皮组织(上皮性卵巢癌37例、交界性卵巢瘤14例、良性卵巢瘤11例、正常卵巢上皮组织12例)中Ki67、PCNA的mRNA表达。结合临床病理指标,进行统计学分析处理。结果①上皮性卵巢癌中Ki67的mRNA和蛋白的阳性表达率及过表达率高于其他组织(P<0.05)。PCNA的mRNA和蛋白的阳性表达率及过表达率在四组之间差异无统计学意义(P>0.05)。两个指标的mRNA和蛋白表达呈正相关(r=0.449,P=0.025;r=0.484,P=0.014)。②Ki67在低分化、Ⅲ-Ⅳ期病例中阳性表达率高,在浆液性卵巢癌中呈过表达,而在其他类型(黏液性、恶性苗勒氏混合瘤、移行细胞癌伴鳞癌分化等)中呈低表达或表达缺失,在其他临床病理指标方面差异无统计学意义。PCNA在上皮性卵巢癌FIGO分期、分化程度,组织学类型及其他临床病理指标的阳性表达率差异均无统计学意义。有丝分裂呈高指数者共72例(66.1%)。低分化、临床晚期病例较高分化和临床早期病例MI高指数者比例高(P<0.05)。③Ki67过表达同时MI高指数卵巢癌患者共有57例,与另外52例非同时Ki67过表达及MI高指数患者比较在临床分期、分化程度及组织学类型之间差异有统计学意义(P<0.05)。④在73例既有原发灶又有转移灶的病例中:原发灶中三者的表达分别为:Ki67蛋白58.9%、PCNA蛋白91.8%、高指数者占61.6%。在转移灶中(腹膜/大网膜)三者的阳性表达率分别为:Ki67蛋白41.1%、PCNA蛋白74.0%、高指数者占38.4%。原发灶中三种指标明显高于转移灶(P<0.05)。Ki67蛋白Objective To analyze the expressions of Ki67,PCNA and mitotic index in ovarian epithelial tumors and their relationship with clinical pathological features.Methods The expressions of Ki67,PCNA protein and mitotic index in ovarian tissues from 20 patients with normal ovarian tissues,28 patients with ovarian benign tumors,20 patients with borderline tumors and 109(73 metastatic ovarian cancer) patients with malignant tumors were retrospectively tested using the American GBI immunohistochemistry two-step method.The expressions of Ki67 and PCNA mRNA were also detected by in situ hybridization(ISH) in ovarian tissues from 37 patients with primary ovarian cancer,14 patients with borderline tumors,11 patients with benign tumors and 12 patients with normal ovarian tissues.The relationship between clinical pathologic parameters and the expressions of Ki67 and,PCNA and mitotic index in human ovarian tumors was analyzed.Results ①The expressions of Ki67 mRNA and protein in ovarian epithelial tumors was higher than in the controls(P=0.003;P=0.009;P=0.001;P=0.001).But no significant differences appeared in the expression and overexpression of PCNA mRNA and pratein(P=0.327;P=0.718;P=0.123;P=0.125).Positive correlations between the expressions of mRNA and protein for Ki67 and PCNA were found(r=0.449,P=0.025;r=0.484,P=0.014).②The expression of Ki67 in ovarian epithelial was higher in low differential carcinoma and at FIGO III-IV stage(P=0.008;P=0.007).The expression of Ki67 protein in serous tumor tissues was high,but low or missed in other types of tumor tissues such as malignant mixed mullerian tumor and transitional cell carcinoma(P=0.018).No significant differences in other clinicopathological features were found.The high expression of PCNA did not coincide with histological grading,clinical stage and histological types(P=0.447;P=0.763;P=0.657).There were 72 patients with high mitotic index(66.1%).The high expression of mitotic index coincided with histological grading and clinical stage,but not with histological types(P=

关 键 词：增殖细胞周期相关核抗原 增殖细胞核抗原 有丝分裂指数 上皮性卵巢癌 

分 类 号：R737.31[医药卫生—肿瘤]