EC组织错配修复蛋白的表达及其临床意义  

Expressions of mismatch repair proteins in endometrial carcinoma tissues and its clinical significance

作　　者：黄启梅 李志芳[2] 潘陶强 喻朝霞 HUANG Qimei;LI Zhifang;PAN Taoqiang;YU Zhaoxia(Department of Pathology,The First Affiliated Anqing People′s Hospital,Anhui Medical University,Anhui Anqing 246000,China;Department of Gynecology and Obstetrics,Anqing Municipal Hospital,Anhui Anqing 246000,China)

机构地区：[1]安徽医科大学附属安庆第一人民医院病理科,安徽安庆246000 [2]安庆市立医院妇产科,安徽安庆246000

出　　处：《中国妇幼健康研究》2023年第3期99-104,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的 探讨子宫内膜癌(EC)组织错配修复蛋白的表达及其临床意义。方法 选择2016年1月至2021年5月在安徽医科大学附属安庆第一人民医院就诊的EC患者152例,收集患者的一般资料,观察MLH1、PMS2、MSH2和MSH6蛋白表达情况,根据MMR蛋白表达缺失情况,将患者分为微卫星稳定(MSS)组及微卫星不稳定(MSI)组,随访1年记录患者复发情况,分析MMR蛋白表达与患者临床病理特征及预后关系。结果 EC患者中MMR蛋白表达总缺失发生率为27.63%,单一MLH1、PMS2、MSH2、MSH6缺失发生率分别为1.97%、1.32%、1.32%、2.63%,MLH1+MSH6、PMS2+MSH2、PMS2+MSH6共同表达缺失发生率分别为9.21%、6.58%、4.61%。MSS组和MSI组在肌层侵犯深度、淋巴脉管侵犯、累及子宫下段、脉管内癌栓、肿瘤家族史方面,差异均有统计学意义(χ^(2)值分别为6.911、8.163、19.229、5.811、15.514,P<0.05);多因素分析显示,肌层侵犯深度≥1/2、存在淋巴脉管侵犯、累及子宫下段、存在脉管内癌栓、存在肿瘤家族史与EC患者MMR蛋白表达缺失相关,OR(95%CI)值分别为2.675(1.437~4.979)、2.413(1.467~3.970)、2.040(1.131~3.680)、2.085(1.374~3.166)、2.863(1.448~5.664),P<0.05。术后1年,MSS组、MSI组复发率分别为17.27%、19.05%,差异无统计学意义(P>0.05)。结论 MMR蛋白表达缺失与EC患者存在淋巴脉管侵犯、累及子宫下段、存在脉管内癌栓相关,MSI与EC患者短期预后无明显关系。Objective To explore expressions of mismatch repair(MMR) proteins in endometrial carcinoma(EC) tissues and its clinical significance.Methods A total of 152 patients with EC who were treated in The First Affiliated Anqing People′s Hospital, Anhui Medical University from January 2016 and May 2021 were enrolled.The general data of the patients were collected.The expressions of MLH1,PMS2,MSH2 and MSH6 were analyzed.According to deletion of MMR proteins, they were divided into microsatellite stability(MSS) group and microsatellite instability(MSI) group.All patients were followed-up for 1 year to record recurrence.The relationships of expressions of MMR proteins with clinicopathological characteristics and prognosis were analyzed.Results The total deletion rate of MMR proteins in EC patients was 27.63%.The incidence rates of single deletion of MLH1,PMS2,MSH2 and MSH6 were 1.97%,1.32%,1.32% and 2.63% respectively.The incidence rates of co-expression deletion of MLH1+PMS2,MSH2+MSH6 and MLH1+MSH2 were 9.21%,6.58% and 4.61% respectively.There were significant differences in depth of muscular invasion, lymphovascular invasion, involvement of lower uterine segment, intravascular cancer embolus and family history of tumors between the two groups(χ^(2)=6.911,8.163,19.229,5.811 and 15.514 respectively, all P<0.05).Multivariate analysis showed that depth of muscular invasion ≥1/2,lymphovascular invasion, involvement of lower uterine segment, intravascular cancer embolus and family history of tumors were correlated with the deletions of MMR proteins in EC patients [OR(95%CI)=2.675(1.437-4.979),2.413(1.467-3.970),2.040(1.131-3.680),2.085(1.374-3.166),2.863(1.448-5.664),all P<0.05].At 1 year after surgery, there was no statistically significant difference in recurrence rate between MSS group and MSI group(17.27% vs 19.05%,P>0.05).Conclusion The deletions of MMR proteins are correlated with lymphovascular invasion, involvement of lower uterine segment and intravascular cancer embolus in EC patients.MSI has no significant relat

关 键 词：子宫内膜癌 错配修复蛋白 微卫星不稳定性 临床病理特征 预后 

分 类 号：R173[医药卫生—妇幼卫生保健]