卵巢上皮性肿瘤的临床病理特征及其细胞周期素D1和p53蛋白表达的研究  

Clinicopathologic analysis and expression of cyclin D1 and p53 of ovarian borderline tumors and carcinomas

作　　者：邵汇琳[1] 沈丹华[1] 薛卫成[1] 李艺[2] 虞有智[1] 

机构地区：[1]北京大学人民医院病理科,100044 [2]北京大学人民医院妇产科,100044

出　　处：《中华妇产科杂志》2007年第4期227-232,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金(30672224)

摘　　要：目的研究卵巢上皮性癌(卵巢癌)和交界性上皮性肿瘤的临床病理特征及其细胞周期素 D1(cyclin D1)和 p53蛋白表达的情况,探讨卵巢癌和交界性上皮性肿瘤在发病机制上的联系。方法分析45例卵巢癌(卵巢癌组)和54例卵巢交界性上皮性肿瘤(交界性肿瘤组)的临床病理资料,采用免疫组化法检测两组组织中 cyclin D1、p53蛋白的表达情况,并分析其与临床病理特征的相关性。结果 (1)临床病理特征:①年龄:交界性肿瘤组平均年龄为42.5岁(14～82岁),中位数年龄41岁;卵巢癌组平均年龄为53.5岁(26～80岁),中位数年龄51岁。②分期:按国际妇产科联盟(FIGO)分期标准,交界性肿瘤组Ⅰ期48例、Ⅱ期3例、Ⅲ期3例;卵巢癌组Ⅰ期6例、Ⅱ期8例、Ⅲ期26例、Ⅳ期5例。③病理类型:交界性肿瘤组以黏液型为主[占56%(30/54)],其次为浆液型[其中普通型11例,微乳头型5例;占30%(16/54)];卵巢癌组以浆液型(其中低度恶性19例,高度恶性3例)为主[占49%(22/45)]。④病理分化程度:卵巢癌组高分化5例,中分化17例,低分化或未分化23例。⑤预后:交界性肿瘤组5年生存率为98%,卵巢癌组为51%,两组比较,差异有统计学意义(P=0.000)。(2)cyclin D1和 p53蛋白的表达及其与卵巢癌和交界性肿瘤临床病理特征的相关性:卵巢癌组 cyclin D1和 p53蛋白的阳性表达率分别为31%(14/45)和56%(25/45),p53蛋白表达强度与病理分化程度呈正相关(r=0.320,P=0.032);交界性肿瘤组 cyclin D1和 p53蛋白的阳性表达率分别为69%(37/54)和6%(3/54)。其中,普通型浆液性交界性肿瘤与高度恶性浆液性癌比较(两者cyclin D1蛋白阳性表达率分别为91%和26%,p53蛋白分别为0和58%),差异有统计学意义(P<0.01);而微乳头型浆液性交界性肿瘤与低度恶性浆液癌比较(两者 cyclin D1蛋白阳性表达率分别为3/5和2/3,p53蛋白分别为1/5和1/3),差异则无统计学意义(P>0.05)。结论 cyclin D1蛋白的过度表达常见于�Objective To study the clinicopathological features and expression of cyclin D1 and p53 in epithelial ovarian tumors, and to investigate the correlation between pathogenesis of ovarian cancer and epithelial borderline tumors. Methods Fifty four cases of ovarian borderline tumors and 45 cases of ovarian carcinomas from the People＇s Hospital, Peking University were reviewed retrospectively. The clinical data and pathological findings were analyzed. Immunohistochemical study of cyclin D1 and p53 was performed in all 99 cases. Results （ 1 ） In borderline tumors, the age of patients ranged from 14 - 82 （ mean age = 42.5） years. International Federation of Gynecology and Obstetrics （FIGO） stage of borderline tumors was stage Ⅰ in 48 cases, stage Ⅱ in 3 cases, and stage Ⅲ in 3 cases. In ovarian carcinomas, the age of patients ranged from 26 - 80 （ mean age = 53.5 ） years. FIGO stage of carcinoma was stage Ⅰ in 6 cases, stage Ⅱ in 8 cases, stage Ⅲ in 26 cases, and stage Ⅳ in 5 cases. In follow-up of 54 cases with borderline tumors the 5-year survival rate was 98% and of 45 cases with carcinomas a 5-year survival rate of 51% was noted. （2） In 54 cases of borderline tumors, mutinous types accounted for 56% （30/54） and serous types accounted for 30% （16/54）. There were 5 cases with micropapillary pattern, 3 cases with peritoneal implants, 3 cases with lymph node involvement, 6 cases with microinvasion, one case with intraepithelial carcinoma, and one case with mural nodules. In 45 cases of carcinomas, serous carcinoma was the most （49% , 22/45）. The remainder included 3 cases of mutinous types, 8 cases of endometrioid types, 6 cases of transitional cell types, 3 cases of mixed phenotype and 3 cases of undifferentiated types. （3） Overexpression of cyclin D1 and p53 was observed in 31% （ 14/45 ） and 56% （25/45） of ovarian carcinomas, respectively. There was a significant association between pS3 overexpression and tumor grade. In the borderline tumor group, 69% （37/

关 键 词：卵巢肿瘤 囊腺癌 浆液 细胞周期蛋白D1 蛋白质P53 

分 类 号：R737.31[医药卫生—肿瘤]