检测PTEN、PI3KCA、Ki67在子宫内膜细胞学筛查子宫内膜癌中的价值  

The value of detecting PTEN,PI3KCA and Ki67 in endometrial cytology screening for endometrial carcinoma

作　　者：刘帅[1] 杨曦[1] 张乃怿[2] 孟轶婷[3] 蔡丹 郭明明 马珂[1] 张蕾[1] 廖秦平[1] LIU Shuai;YANG Xi;ZHANG Naiyi;MENG Yiting;CAI Dan;GUO Mingming;MA Ke;ZHANG Lei;LIAO Qinping(Department of Gynecology and Obstetrics,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Gynecologic Oncology,Peking University Cancer Hospital,Beijing 100142,China;Department of Pathology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Gynecology and Obstetrics,Xinjiang Uygur Autonomous Region Kunyu People’s Hospital,Xinjiang 848116,China)

机构地区：[1]清华大学临床医学院,清华大学附属北京清华长庚医院妇产科,北京102218 [2]北京大学肿瘤医院妇瘤科,北京100142 [3]清华大学临床医学院,清华大学附属北京清华长庚医院病理科,北京102218 [4]新疆维吾尔自治区昆玉市人民医院妇产科,新疆848116

出　　处：《中国妇产科临床杂志》2023年第1期29-32,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京市优秀人才骨干个人项目(201700021469G255);北京市医院管理中心青年人才培养“青苗”计划(QML20210902)。

摘　　要：目的 检测PTEN、PI3KCA、Ki67在不同子宫内膜组织和细胞中的表达,评价三个分子标志物在提高子宫内膜细胞学筛查子宫内膜癌准确性中的价值。方法 选取2016年3月至2020年3月在北京清华长庚医院妇产科行宫腔镜检查的患者95例。其中内膜癌组40例,良性病变组30例,正常子宫内膜组25例。在宫腔镜检查前行子宫内膜细胞采集,行PTEN、PI3KCA、Ki67的免疫细胞化学(ICC)检测,半定量法评估表达水平,分别绘制ROC曲线,与内膜组织的免疫组织化学(IHC)进行对比,评价以上三个指标在筛查内膜癌中的价值。结果PTEN、PI3KCA、Ki67在内膜癌组、良性病变组和正常组中的ICC表达程度与IHC表达呈正相关。使用ICC和IHC检测,均可发现PTEN在正常组和良性病变组的表达显著高于内膜癌组,PI3KCA和Ki67在内膜癌组的表达显著高于正常组和良性病变组(P <0.01)。应用ICC方法检测,以PTEN≤35%作为内膜癌诊断指标时,灵敏度为95%,特异度为66.7%。以PI3KCA≥20%作为内膜癌诊断指标时,灵敏度为100%,特异度为78.5%。以Ki67≥15%作为内膜癌诊断指标时,灵敏度为100%,特异度为82.5%。结论 应用子宫内膜细胞学筛查内膜癌过程中加入PTEN、PI3KCA、Ki67检测,能提高诊断的灵敏度和特异度,可以在一定程度上提高诊断准确率。Objective To detect the expression of PTEN,PI3KC A and Ki67 in different endometrial tissues and cells,and to evaluate the value of these markers in improving the accuracy of endometrial cytology screening for endometrial cancer.Methods A total of 95 patients underwent hysteroscopy from March 2016 to March 2020 in the Department of Gynecology of Tsinghua Changgung Hospital were selected,including 40 cases with endometrial carcinoma,30 cases with benign lesion and 25 cases with normal endometrial.Endometrial cells were collected before hysteroscopy for immunocytochemistry(ICC) and immunohistochemistry(IHC) detection of PTEN,PI3KCA and Ki67.The expression levels were evaluated by semi-quantitative method and ROC curves were drawn to evaluate the application value of the three indicators in the screening for endometrial cancer.Results ICC expression of PTEN,PI3KCA and Ki67 was positively correlated with IHC expression in all three groups.The expression of PTEN in normal group and benign group were significantly higher than that in endometrial cancer group,and the expression of PI3KCA and Ki67 in endometrial cancer group were significantly higher than that in normal group and benign group(P<0.01).The sensitivity and specificity of ICC were 95% and 66.7% respectively when PTEN ≤35% was used as the diagnostic index of endometrial cancer.The sensitivity and specificity were 100% and 78.5% respectively when PI3KCA≥ 20% was used.The sensitivity and specificity were 100% and 82.5% respectively when Ki67≥15% was used.Conclusion The detection of PTEN,PI3KCA and Ki67 in endometrial cytology screening for endometrial carcinoma can improve the sensitivity and specificity of diagnosis,and can improve the diagnostic accuracy to a certain extent.

关 键 词：子宫内膜细胞学 PTEN PI3KCA KI67 子宫内膜癌 

分 类 号：R737.33[医药卫生—肿瘤]