子宫内膜癌患者不同激素受体表型下增殖和凋亡指标的表达变化及临床意义  

Expression changes and clinical significance of proliferation and apoptosis indices under different hormone receptor phenotypes in patients with endometrial carcinoma

作　　者：黄利珊 魏伟锋[1] 梁晔 赵花 HUANG Li-shan;WEI Wei-feng;LIANG Ye;ZHAO Hua(Depart-ment of Gynecology,Meizhou People's Hospital,Meizhou,Guangdong Province 514011,China)

机构地区：[1]梅州市人民医院妇科,广东梅州514011

出　　处：《解剖学研究》2022年第5期461-465,共5页Anatomy Research

基　　金：广东省医学科学技术研究基金项目(C2018052)。

摘　　要：目的探讨子宫内膜癌患者不同激素受体表型下增殖和凋亡指标的表达变化及临床病理参数的关系。方法纳入于2016年1月-2020年10月我院就诊的89例子宫内膜样癌患者作为研究对象,采用免疫组化染色技术检测子宫内膜癌组织中ER和PR的表达情况,并根据其激素表型分为ER(+)PR(+)组、ER(-)PR(-)组、ER(+)PR(-)组和ER(-)PR(+)组,比较给组中增殖指标Ki⁃67、凋亡指标p53的表达差异,并分析上述指标与子宫内膜样癌临床病理参数及淋巴结转移的相关性。结果在子宫内膜样癌患者中,ER、PR的总阳性率为82.02%和69.66%,在ER(+)PR(+)组、ER(-)PR(-)组、ER(+)PR(-)组和ER(-)PR(+)组,p53、Ki⁃67的表达差异均有统计学意义(P<0.05)。随着临床分期的增加,ER、PR的阳性表达率降低,而p53、Ki⁃67的阳性表达率升高,淋巴结转移患者的p53(P=0.023)、Ki⁃67阳性表达率均高于无淋巴结转移患者,淋巴结转移患者的ER、PR(P=0.021)阳性表达率均低于无淋巴结转移患者。在浸入深肌层组中,ER、PR的表达明显低于浅肌层组,但p53和Ki⁃67的表达阳性率高于浅肌层组(P<0.05)。结论p53、Ki⁃67阳性表达与子宫内膜样癌患者的临床分期、淋巴结转移、浸润深度均呈正相关,ER、PR阳性表达与则呈负相关p53、Ki⁃67与患者不同激素受体表型有关,可能参与到子宫内膜样癌的发生、发展过程。Objective To investigate the expression changes of proliferation and apoptosis indexes under different hormone receptor phenotypes and the relationship between clinicopathological parameters in patients with endometrial can⁃cer.Methods A total of 89 patients with endometrial carcinoma treated in our hospital from January 2016 to October 2020 were included as research subjects.Immunohistochemical staining was used to detect the expression of ER and PR in endo⁃metrial carcinoma tissues.According to their hormone phenotypes,they were divided into ER(+)PR(+)group,ER(-)PR(-)group,ER(+)PR(-)group and ER(-)PR(+)group.The expression differences of proliferation index Ki⁃67 and apop⁃tosis index p53 in these groups were compared,and the correlation between these indexes and clinicopathological parameters of endometrioid carcinoma and lymph node metastasis was analyzed.Results In patients with endometrioid carcinoma,the total positive rates of ER and PR were 82.02%and 69.66%,and the expressions of p53 and Ki⁃67 in ER(+)PR(+)group,ER(-)PR(-)group,ER(+)PR(-)group and ER(-)PR(+)group were significantly different(P<0.05).With the in⁃crease of clinical stage,the positive expression rates of ER and PR decreased,while the positive expression rates of p53 and Ki⁃67 increased.The positive expression rates of P53 and KI⁃67 in patients with lymph node metastasis(P=0.023)were higher than those in patients without lymph node metastasis.The positive expression rates of ER and PR in patients with lymph node metastasis were lower than those in patients without lymph node metastasis(P=0.021).The expression of ER and PR in deep muscle layer group was significantly lower than that in superficial muscle layer group,but the positive ex⁃pression of p53 and Ki⁃67 was higher than that in superficial muscle layer group(P<0.05).Conclusion Positive expres⁃sions of p53 and KI⁃67 are positively correlated with clinical stage,lymph node metastasis and invasion depth of patients with endometrioid carcinoma,while positive expressio

关 键 词：子宫内膜样癌 P53抑癌基因 核增殖抗原(Ki⁃67) 雌激素受体 孕激素受体 

分 类 号：R737.33[医药卫生—肿瘤]