机构地区:[1]山西医科大学,山西太原030001 [2]山西医科大学第一附属医院病理科,山西太原030001 [3]山西省晋中市中医院妇产科,山西晋中030600
出 处:《世界最新医学信息文摘》2017年第19期5-7,共3页World Latest Medicine Information Electronic Version
摘 要:目的探讨子宫内膜癌中错配修复基因、CD4、Ki-67的表达及相互作用,为理解子宫内膜癌的发生发展、分子分型提供理论和实验依据。方法选择有完整临床病理资料的术前未经过放化疗及内分泌经治疗的散发性宫内膜样癌根治术后存档的腊块标本80例。应用免疫组织化学方法检测不同分级及分期肿瘤中的错配修复基因中四种主要蛋白MLH l、MSH2、MSH6和PMS2及CD4、Ki-67表达情况,探讨错配修复基因在散发性子宫内膜样癌中的表达和意义。结果 1.MMR表达缺失在子宫内膜样癌中的发生率为:21.25%,其中单个蛋白表达缺失14例,两个蛋白联合缺失3例。2.PMS2的缺失率最高,占41.18%(7/17),其次为MSH2和MSH6均为29.41%(5/17),MLH1缺失最为少,占17.65%。3.Ⅰ级病变中多数表现为单个MMR蛋白表达缺失,也可有2个蛋白组合的联合表达缺失,分别为MSH2/MSH6共缺失2例,MLH1/PMS2共缺失1例。Ⅱ级病变中仅检测到MMR单个蛋白表达缺失,未在Ⅲ级病变中检测到MMR表达缺失。4.MMR表达缺失主要发生于Ⅰ期及40岁以下患者,尤其以Ⅰa期患者多见。Ⅰa期患者常见的缺失类型为MSH6(4/9),40岁及以下的患者中MSH2为最常见的缺失类型,大于40岁的患者以PMS2的缺失最为常见。5.具有MMR表达缺失的子宫内膜样癌病例较无MMR表达缺失病例而言,有着更高的细胞免疫水平和更低的肿瘤细胞的增殖活性(P<0.05)。结论 1.MMR参与了散发性子宫内膜样癌的发生发展,利用免疫组化方法可以很好的检测到组织中MMR的状态;2.PMS2和MSH2/MSH6共缺失是在子宫内膜样癌中的最常见的缺失类型;3.MMR表达缺失主要发生于Ⅰ期及40岁以下患者;4.MMR表达缺失提高了子宫内膜样癌患者的细胞免疫水平,降低了细胞增殖活性。Objective to investigate expression and interactive effect of mismatch repair genes,CD4 and Ki-67 in endometrial carcinoma,and to provide theoretical and experimental basis for understanding occurrence and development of endometrial carcinoma and molecula.Methods choose 80 cases archived paraffin embedded specimens of sporadic endometrioid carcinoma after radical correction with complete clinical and pathological data,who had not received radiotherapy,chemotherapy and endocrine therapy before operation.Detect expression of 4 main protein,MLH l,MSH2,MSH6,PMS2 and CD4,Ki-67 in mismatch repair genes of carcinoma with different grades and stages with immunohistochemical method,to investigate expression and significance of mismatch repair genes in sporadic endometrioid carcinoma.Results 1.incidence of MMR expression deficiency in endometrial carcinoma was 21.25%,among which,there were 14 cases single protein expression deficiency,and 3 cases combination deficiency of two proteins.2.PMS2 deficiency incidence rate was the highest,accounting for 41.18%(7/17),followed by MSH2 and MSH6,was all 29.41%(5/17),and MLH1 deficiency was the least,accounting for 17.65%.3.in grade I lesions,most deficiency showed single MMR protein expression,and there was some combination expression deficiency of 2 proteins,including 2 cases MSH2/MSH6 deficiency,1 case MLH1/PMS2 deficiency.In grade II lesions,there was only single MMR protein expression deficiency,and there was no MMR expression deficiency in grade III lesions.4.MMR expression deficiency mainly occurred in patients of stage I and under 40,especially in patients with stage Ia.The most common deficiency type of stage Ia patients was MSH6(4/9),the most common deficiency type was MSH2 in patients of 40 and under,and that of patients above 40 was PMS2.5.endometrioid carcinoma cases with MMR expression deficiency showed higher cellular immunity level and lower proliferative activity of tumor cell than those without MMR expression deficiency(P〈 0.05).Conclusion 1.MMR pa
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