错配修复蛋白在子宫内膜活检组织中的表达  

Expression of MMR in Pre-operative endometrial specimens

作　　者：古丽米拉.巴依坦 陆洁 王慧[3] 刘霞[3] 

机构地区：[1]新疆维吾尔自治区人口和计划生育科学技术研究所病理科,乌鲁木齐830011 [2]新疆维吾尔自治区医疗卫生服务管理指导中心,乌鲁木齐830011 [3]新疆医科大学第一附属医院病理科,乌鲁木齐830054

出　　处：《新疆医学》2016年第10期1256-1259,共4页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区科技计划(201233142)

摘　　要：目的探讨错配修复基因（mismatch repair gene,MMR）MLH1、MSH2、PMS2和MSH6蛋白在子宫内膜活检组织中的表达情况,并分析4种蛋白的表达与子宫内膜腺癌的发生与患者年龄的关系,为早期病变及高危人群提供有效的参考指标。方法子宫内膜腺癌患者作为实验组,子宫内膜非典型增生、子宫内膜复杂性增生和正常周期子宫内膜病例作为对照组,采用免疫组化En Vision法检测MMR蛋白,分别进行比较,观察上述4种蛋白在不同子宫内膜活检组织中的表达规律,应用SPSS19.0统计软件进行统计学分析。结果 40例子宫内膜腺癌活检组织中20例（50%）有一个以上MMR蛋白表达阴性,在不典型增生、复杂性增生和正常周期子宫内膜组中一个以上为阴性表达比例分别为9例（30%）、10例（33%）、4例（13%）,各组间的差异有统计学意义（P=0.014）。子宫内膜腺癌中MMR蛋白阴性表达率分别为MLH1 37.5%（15/40）、MSH2 15.0%（6/40）、PMS220.0﹪（8/40）、MSH6（0/0）;与对照组分别进行比较,MLH1和PMS2的表达差异均有统计学意义（P〈0.05）,MSH2和MSH6的表达差异均无统计学意义（P〉0.05）。子宫内膜腺癌患者50岁以下,50~60岁,〉60岁3个年龄组间4种MMR蛋白一个以上为阴性的比例为6/11、8/17、7/12,各组间差异无统计学意义（P〉0.05）,但MLH1、MSH2和PMS2的阴性表达更倾向发生在50~60岁患者中。结论 MMR基因突变与非典型增生及子宫内膜腺癌的发生有一定的相关性,在临床病理指标上4种MMR蛋白缺失表达与患者的年龄无明显相关性。Objective To analyze the expression of DNA mismatch repair（MMR）genes（MLH1,MSH2,PMS2 and MSH6） in pre-operative endometrial specimens and explore the relationship among MMR,clinical pathological features and ages of patients with endometrial adenocarcinoma（EC）.Methods MMR gene expression was investigated by immunohistochemical En Vision method in pre-operative endometrial specimens of patients with endometrial adenocarcinoma.Specimens for patients with atypical hyperplasia endometrium,complexity hyperplasia endometrium,or normal endometrium were chosen and compared as control groups.Expression of MLH1,MSH2,PMS2 and MSH6 gene were determined.SPSS 19.0 software was used to analyze the results.Results There were twenty cases among 40 cases with endometrioial adenocarcinoma（50%） who lost at least one MMR protein expression.While there were 9 cases（30%）who lost at least one MMR protein expression in groups with atypical hyperplasia endometrium,10 cases（33%）in groups with complexity hyperplasia endometrium and 4 cases（13%）in groups with normal endometrium respectively（P =0.014）.Rates of loss expression in group with endometrial adenocarcinoma were as follows：MLH1 was 37.5%（15/40）、MSH2 was 15.0%（6/40） and PMS2 was20.0%（8/40）,respectively.The difference between MLH1 and PMS2 expression among four groups were statistically significant（P〈0.05）,but the expression of MSH2 and MSH6 showed no significant difference among four groups（P〈0.05）.The expression of MMR protein was not related with ages of patients although loss of MLH1、MSH2 and PMS2 was more frequently seen in 50-60 years old patients.Conclusion The loss expression of MMR proteins is correlated with the development of EC from atypical hyperplasia.the expression of MMR proteins in EC has no significant relationship with patients ages.

关 键 词：子宫内膜腺癌 错配修复基因(MMR) 免疫组织化学 活检 

分 类 号：R365[医药卫生—病理学]