α-平滑肌肌动蛋白在低分化子宫内膜癌中的预后意义  

Prognostic significance ofα-SMA in the tumor microenvironment of poorly differentiated endometrial carcinoma

作　　者：陈茜 刘芳芳[2] 赵颖[3] 程媛[1] 赵娜[1] 王建六[1] CHEN Xi;LIU Fangfang;ZHAO Ying;CHENG Yuan;ZHAO Na;WANG Jianliu(Department of Obstetrics and Gynecology,Peking University People’s Hospital,Beijing 100044,China;Department of pathology,Peking University People’s Hospital,Beijing 100044,China;Department of Biochemistry and Molecular biology,School of Basic Medical Sciences,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学人民医院妇产科,北京100044 [2]北京大学人民医院病理科,北京100044 [3]北京大学医学部基础医学院,生物化学与分子生物学系,北京100191

出　　处：《中国妇产科临床杂志》2023年第6期619-622,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家自然科学基金(82072861、81672571)。

摘　　要：目的探讨α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)在低分化子宫内膜癌(endometrial carcinoma,EC)肿瘤微环境(tumor microenvironment,TME)中的预后意义。方法收集北京大学人民医院2013年3月至2020年12月具有完整临床和病理资料的低分化子宫内膜癌患者45例,其中17例病理分级G3级子宫内膜样腺癌(endometrioid endometrial carcinoma,EEC)、16例子宫内膜浆液性癌(endometrial serous carcinoma,ESC)和12例子宫内膜透明细胞癌(endometrial clear cell carcinoma,ECCC)。采用免疫组化方法检测α-SMA、CD10和Desmin的表达;Trichrome特染方法检测胶原纤维的表达。采用Keplan-Meier法计算累计生存率,Log Rank检验比较生存时间分布的组间差异性。结果α-SMA在低分化子宫内膜癌中的总表达率为71.1%(32/45)。α-SMA在EEC、ESC和ECCC的肿瘤微环境中的阳性表达率分别为82.4%(14/17)、62.5%(10/16)和66.7%(8/12)。所有α-SMA阳性患者均同时具有胶原纤维形成,当α-SMA表达阴性时,未见胶原纤维形成。α-SMA阳性组的总生存率明显低于阴性组(P=0.041)。结论α-SMA在低分化子宫内膜癌肿瘤微环境中提示不良预后。Objective To study the prognostic significance ofα-smooth muscle actin(α-SMA)in the tumor microenvironment(TME)of poorly differentiated endometrial carcinoma(EC).Methods A total of 45 cases of poorly differentiated EC from March 2013 to December 2020 was collected in the study.There were 17 cases of grade 3 endometrioid endometrial carcinomas(EECs),16 cases of endometrial serous carcinomas(ESCs),and 12 cases of endometrial clear cell carcinomas(ECCCs).The expression ofα-SMA,CD10,and desmin was detected in the TME by the immunohistochemical method.Trichrome was detected to identify collagen in TME by a special dyeing method.Betweengroup comparison in categorical variables was assessed via using Fisher’s exact test.The overall survival was analyzed by a Kaplan-Meier curve.Results The total expression rate ofα-SMA in endometrial carcinoma was 71.1%(32/45).The expression rate ofα-SMA was 82.4%(14/17),62.5%(10/16)and 66.7%(8/12)positively expressed in EEC,ESC,and ECCC,respectively.Allα-SMA positive patients had concurrent collagen fiber formation,and no collagen fiber formation was observed whenα-SMA expression was negative.Bothα-SMA and Trichrome positive groups showed significantly poorer prognosis(P=0.041)than bothα-SMA and Trichrome negative groups.Conclusion The expression ofα-SMA is of great significance in predicting the poor prognosis of endometrial cancer.

关 键 词：子宫内膜癌 免疫组化 Α-平滑肌肌动蛋白 胶原纤维 预后 

分 类 号：R737.33[医药卫生—肿瘤]