细胞角蛋白、CA_(125)对子宫内膜癌淋巴结微转移的诊断价值  

Study on cytokeratin and CA_(125) for diagnosing lymph node micrometastases in endometrial cancer

作　　者：刘风华[1] 王沂峰 王静[3] 薛强[3] 江森[1] 马玉燕[1] 

机构地区：[1]山东大学齐鲁医院妇产,济南250012 [2]广州市第二人民医院妇产科 [3]济南市第四人民医院病理科

出　　处：《中华妇产科杂志》2004年第9期612-615,i002,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　研究细胞角蛋白 (cytokeratin ,CK)、CA12 5对子宫内膜癌淋巴结微转移的诊断价值 ,及其作为子宫内膜癌复发危险因素的临床意义。方法　采用免疫组化链霉菌抗生物素蛋白 过氧化物酶连接 (SP)法检测 5 0例子宫内膜癌患者的原发灶组织 5 0份和淋巴结 2 98枚中CK、CA12 5的表达情况 ,采用多元回归分析法对影响子宫内膜癌复发的危险因素进行分析。结果　 (1)CK、CA12 5在子宫内膜癌组织中的阳性表达率分别为 10 0 % (5 0 / 5 0 )和 78% (39/ 5 0 )。 (2 )HE染色检查有转移的淋巴结中 ,CK和CA12 5均呈强阳性表达的阳性表达率均为 10 0 % (16 / 16 )。HE染色检查无转移的淋巴结中 ,CK、CA12 5的阳性表达率分别为 15 % (4 3/ 2 82 )和 12 % (35 / 2 82 ) ,且均为弱阳性表达。 (3)Ⅰ、Ⅱ期子宫内膜癌患者淋巴结中 ,CK阳性与CK阴性表达者的复发率分别为 38%、0 ,两者比较 ,差异有显著性 (P <0 0 5 ) ;CA12 5阳性与CA12 5阴性表达者的复发率分别为 39%、4 % ,两者比较 ,差异也有显著性 (P <0 0 5 )。 (4 )多元回归分析结果显示 ,淋巴结中CK表达是影响Ⅰ、Ⅱ期子宫内膜癌复发的独立危险因素 ,而淋巴结中CA12 5表达和肌层浸润深度均为影响Ⅰ、Ⅱ期子宫内膜癌复发的相关因素。Objective To study the roles of cytokeratin(CK) and CA_(125) in diagnosing lymph node micrometastasis in endometrial cancer. Methods The expressions of CK and CA_(125) in 50 primary tumors and 298 lymph nodes from 50 patients with endometrial cancers were analysed by immunohistochemical methods. Results (1)The positive expression rates of CK and CA_(125) in primary tumors of cases with endometrial cancer were respectively 100%, and 78%. (2)The expressions of CK and CA_(125) in metastatic lymph nodes were both strong with 100% positive rate. In lymph nodes without metastasis, the expressions of CK and CA_(125) were both weak, with positive rates of 15% and 12% respectively. (3)Among patients with stageⅠ,Ⅱ diseases, tumor recurrence rate was significantly higher in patients with positive CK or CA_(125) expression in lymph nodes than in patients without CK or CA_(125) expression (P<0.05). (4) Multiple regression analysis revealed that in stagesⅠ, Ⅱ endometrial cancer, CK expression in lymph nodes, and CA_(125) expression in lymph nodes together with depth of myometrial invasion were relevant factors with tumor recurrence. Conclusions CK expression in lymph nodes without metastasis can predict lymph node micrometastasis and is an independent risk factor for recurrence of disease in stagesⅠ,Ⅱ endometrial cancers. CA_(125) expression in lymph nodes without metastasis can also suggest lymph node micrometastasis, but it is not an independent predictive factor for tumor recurrence in stagesⅠ,Ⅱ endometrial cancers.

关 键 词：子宫内膜癌 CA125 CK 表达 淋巴结微转移 癌复发 细胞角蛋白 链霉菌 过氧化物酶 生物素 

分 类 号：R737.33[医药卫生—肿瘤]