胎盘碱性磷酸酶在子宫内膜样腺癌与子宫内膜增生性疾病中的表达及临床意义  

Expressions and clinical significance of placental alkaline phosphatase in endometrioid adenocarcinoma and endometrial hyperplastic related diseases

作　　者：郭祎男 宣可 张海雁 张瑜 杜红雁 翟江萍 邹雪婷 宋双敏 郭春利 GUO Yi-nan;XUAN Ke;ZHANG Hai-yan;ZHANG Yu;DU Hong-yan;ZHAI Jiang-ping;ZOU Xue-ting;SONG Shuang-min;CUO Chun-li(Northwest Women and Children's Hospital Afiliated to Xi'an Jiaotong University,Xian,Shaanxi 710000,China;不详)

机构地区：[1]西安交通大学附属西北妇女儿童医院,陕西西安710000 [2]西安新长安妇产医院

出　　处：《中国妇幼保健》2024年第10期1854-1857,共4页Maternal and Child Health Care of China

基　　金：陕西省西安市卫生健康委员会科研项目(2022yb37);西北妇女儿童医院院内科研项目(2022YN30)。

摘　　要：目的 分析胎盘碱性磷酸酶(PLAP)表达阳性部位的差异及对子宫内膜非典型增生与子宫内膜样腺癌鉴别诊断的意义。方法 选取2015年1月-2022年12月西北妇女儿童医院病理科和西安新长安妇产医院病理科共140例子宫内膜标本,包括20例增殖期子宫内膜,20例子宫内膜简单性增生,20例子宫内膜复杂性增生,20例子宫内膜非典型增生及60例不同分化程度的子宫内膜样腺癌。进行免疫组化染色,采用H-score评分法观察PLAP表达情况并记录;收集TCGA、GEO、ArrayExpress、Oncomine数据库提供的子宫内膜样腺癌相关数据,对PLAP mRNA在子宫内膜样腺癌组织中的表达及诊断效能进行Meta分析。结果 PLAP在各类子宫内膜标本中的阳性表达情况:子宫内膜样腺癌(高分化)中阳性率为46.7%,子宫内膜样腺癌(中分化)中阳性率为66.7%,子宫内膜样腺癌(低分化)中阳性率为66.7%,子宫内膜非典型增生中阳性率为65.0%,子宫内膜复杂性增生中阳性率为15.0%,子宫内膜简单性增生中阳性率为10.0%,增殖期子宫内膜中阳性率为10.0%。子宫内膜样腺癌、子宫内膜非典型增生、增殖期子宫内膜+子宫内膜简单性增生+子宫内膜复杂性增生中PLAP表达的H-score比较,差异有统计学意义(P<0.05)。结论 PLAP的免疫组化染色有助于子宫内膜非典型增生与子宫内膜样腺癌的诊断及鉴别诊断。Objective To analyze the difference of placental alkaline phosphatase(PLAP)positive expression sites and the signifi-cance of PLAP in differential diagnosis of endometrial atypical hyperplasia and endometrial adenocarcinoma.Methods From January 2015 to November 2022,140 samples of endometrium in Department of Pathology of Northwest Women and Children's Hospital and Xi'an New Chang'an Maternity Hospital were selected,including 20 cases of endometrium during proliferating phase,20 cases of simple endometrial hy-perplasia,20 cases of complex endometrial hyperplasia,20 cases of endometrial atypical hyperplasia,and 60 cases of endometrioid adenocar-cinoma of different differentiated degrees.Immunohistochemical staining was performed,and H-score was used to observe the expression of PLAP.Data related to endometrial adenocarcinoma were collected from TCGA,GEO,Arrayexpress,and Oncomine databases,and Meta a-nalysis was performed on the expression of PLAP mRNA in endometrial adenocarcinoma tissues and its diagnostic efficacy.Results The pos-itive rates of PLAP in endometrial adenocarcinoma(high differentiation),endometrial adenocarcinoma(middle differentiation),endometrial adenocarcinoma(low differentiation),endometrial atypical hyperplasia,complex endometrial hyperplasia,simple endometrial hyperplasia,and endometrium during proliferating phase were 46.7%,66.7%,66.7%,65.0%,15.0%,10.0%,and 10.0%,respectively.There was statistically significant difference in H-score of PLAP expression among endometrial adenocarcinoma,endometrial atypical hyperplasia,en-dometrium during proliferating phase+simple endometrial hyperplasia+complex endometrial hyperplasia(P<0.05).Conclusion 1Immuno-histochemical staining of PLAP is helpful for the diagnosis and differential diagnosis of endometrial atypical hyperplasia and endometrioid ade-nocarcinoma.

关 键 词：子宫内膜非典型增生 子宫内膜样腺癌 胎盘碱性磷酸酶 

分 类 号：R711.74[医药卫生—妇产科学]