抑癌基因PTEN、P27在子宫内膜癌及癌前病变中的表达及其临床意义  

Expressions and clinical significance of tumor suppressor genes PTEN and P27 in endometrialcarcinoma and precancerous lesions

作　　者：李少星[1] 余华[1] 杨惠欢 刘战立[1] LI Shaoxing;YU Hua;YANG Huihuan;LIU Zhanli(The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China;Xinjin People's Hospital, Chengdu 610000, China)

机构地区：[1]成都医学院第一附属医院,四川成都610500 [2]新津县人民医院,四川成都611430

出　　处：《西部医学》2021年第8期1215-1219,共5页Medical Journal of West China

基　　金：四川省医学会科研课题资助项目(S18012)。

摘　　要：目的 探讨免疫组织化学法检测抑癌基因PTEN、P27在子宫内膜癌(EC)及癌前病变中的表达水平及其临床意义。方法 回顾性收集2015年6月~2020年1月成都医学院第一附属医院确诊为EC患者的存档癌组织蜡块35例,同时选取同期存档的39例内膜增生过长(不伴不典型)、26例子宫内膜不典型增生和35例正常子宫内膜组织蜡块。按组织类型不同分为正常子宫内膜组、子宫内膜增生过长组、子宫内膜不典型增生组和EC组。采用免疫组织化学法对各组组织中抑癌基因PTEN及P27的表达进行检测,并分析其与EC组织病理分级、临床分期、肌层浸润深度、淋巴结转移及组织学病理类型的关系。分析子宫内膜不典型增生及EC组织中PTEN及P27蛋白表达的相关性。结果 PTEN及P27在正常子宫内膜、内膜增生过长、内膜不典型增生及EC组织中阳性表达率呈逐渐下降(P<0.05);PTEN及P27的表达随着EC病理分级升高而显著降低(P<0.05);内膜样癌组织中PTEN及P27阳性率明显低于非内膜样癌组织(P<0.05);而PTEN及P27的表达与EC临床分期、肌层浸润深度及淋巴结转移无关(P>0.05);子宫内膜不典型增生及EC组织中PTEN及P27蛋白表达正相关(均P<0.05)。结论 抑癌基因PTEN、P27表达缺失是子宫内膜癌发生的早期事件,采用免疫组织化学法检测PTEN及P27基因有助于鉴别EC及癌前病变,且对EC的癌变程度有一定的评估作用。Objective To apply immunohistochemistry to detect the expressions levels and clinical significance of tumor suppressor genes PTEN and P27 in endometrial carcinoma and precancerous lesions. Methods 35 cases of cancer tissue wax were collected from June 2015 to January 2020 in the First Affiliated Hospital of Chengdu Medical College. Meanwhile, 39 cases of endometrial hyperplasia (without atypical), 26 cases of atypical hyperplasia and 35 normal endometrial wax blocks were selected. They were divided into normal endometrium group, endometrial hyperplasia group, endometrial atypical hyperplasia group and EC group. The expression of PTEN and p27 in each group was detected by immunohistochemistry. The relationship between EC and the histopathological classification, clinical stage, depth of myometrial invasion, lymph node metastasis and histopathological type were analyzed. The correlation between PTEN and p27 protein expression in endometrial atypical hyperplasia and EC was analyzed. Results The positive expression rates of PTEN and P27 in normal endometrium, endometrial hyperplasia, endometrial atypical hyperplasia and EC tissues gradually decreased (P<0.05). The expressions of PTEN and P27 decreased significantly with the increase of EC pathological grade (P<0.05). The positive rates of PTEN and P27 in endometrial carcinoma tissues were significantly lower than those in non-endometrium carcinoma tissues (P<0.05). The expressions of PTEN and P27 had nothing to do with EC pathological stage, basal invasion depth and lymph node metastasis (P>0.05). There was a positive correlation between and PTEN protein expression and P27 protein expression in endometrial atypical hyperplasia and EC tissues (r=0.402, 0.712, P<0.05). Conclusion Loss of expressions of tumor suppressor genes PTEN and P27 is an early event of endometrial carcinoma. The detection of PTEN and P27 genes by immunohistochemistry is helpful to distinguish EC and precancerous lesions, and has a certain role in assessing the canceration degree of EC.

关 键 词：免疫组织化学法 子宫内膜癌 癌前病变 PTEN P27 

分 类 号：P737.33[天文地球—海洋地质]