HMGA2作为子宫内膜浆液性癌早期诊断分子标记物的价值评估  

Evaluation of HMGA2 as a molecular marker for early diagnosis of endometrial serous carcinoma

作　　者：魏麟萱 王雅芬[2] Wei Linxuan;Wang Yafen(Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University,Jinan 250012;Department of Obstetrics and Gynecology,the Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250033)

机构地区：[1]山东大学齐鲁医院妇产科,济南250012 [2]山东大学第二医院妇产科,济南250033

出　　处：《现代妇产科进展》2024年第12期890-894,共5页Progress in Obstetrics and Gynecology

基　　金：山东省自然科学基金(No:ZR2020QH251)。

摘　　要：目的:评估HMGA2在子宫内膜浆液性癌(ESC)发生发展各阶段的表达情况,探讨HMGA2作为ESC早期诊断分子标记物的价值。方法:选取病理诊断明确的子宫内膜浆液性癌(ESC)41例、子宫内膜上皮内癌(EIC)8例、子宫内膜腺体异常增生(EmGD)13例,静止期子宫内膜(RE)样本15例,子宫内膜良性病变样本8例,免疫组化染色法检测HMGA2和p53表达,探讨HMGA2能否联合p53提高ESC的早期诊断率。结果:随着疾病进展,HMGA2在EmGD(8/13,61.5%)、EIC(5/8,62.5%)、ESC(28/41,68.3%)中的免疫组化阳性率逐渐升高。ESC(3/41)、EIC(1/8)到EmGD(2/13)均存在p53阴性而HMGA2阳性的病例,提示HMGA2与p53免疫组化结果可互为补充。EIC中,HMGA2联合p53,将其诊断检出率从75%提高到了87.5%;EmGD中,HMGA2联合p53,将其诊断检出率从61.5%提高到了77.1%,差异均有统计学意义(P<0.05)。绝大多数(22/23,95.7%)形态学正常的内膜样本及良性病变样本中p53和HMGA2表达均为阴性。仅1例形态学正常但p53阳性的“p53印记”(p53 Signature)样本中HMGA2也为阳性,表明HMGA2在ESC极早期阶段就已发生表达异常。结论:HMGA2在ESC发生的极早期阶段就已存在表达异常,可联合p53,作为ESC早期诊断标记物,有效提高EmGD、EIC的临床诊断检出率,降低误诊率,具有较高的临床实际应用价值。HMGA2与ESC的不良预后明显相关,有成为ESC分子靶向治疗靶点的可能性。Objective:To evaluate the expression of HMGA2 in the progression of endometrial serous carcinoma(ESC)to explore the value of HMGA2 as a molecular marker for early diagnosis of ESC.Method:41 cases of endometrial serous carcinoma(ESC),8 cases of endometrial intraepithelial carcinoma(EIC),13 cases of endometrial glandular dysplasia(EmGD),15 cases of quiescent endometrial(RE)and 8 cases of benign endometrial lesions were selected.The expressions of HMGA2 and p53 were detected by immunohistochemical staining.Whether HMGA2 combined with p53 could improve the early diagnosis of ESC was statistically analyzed.Results:With the progression of the disease,the immunohistochemical positive rate of HMGA2 increased gradually in EmGD(8/13,61.5%),EIC(5/8,62.5%)and ESC(28/41,68.3%).From ESC(3/41),EIC(1/8)to EmGD(2/13),p53 negative and HMGA2 positive cases were found,suggesting that the immunohistochemical results of HMGA2 and p53 could complement with each other.In EIC,HMGA2 combined with p53 increased the diagnostic detection rate from 75%to 87.5%.In EmGD,HMGA2 combined with p53 increased the diagnostic detection rate from 61.5%to 77.1%,and the differences were statistically significant.The expressions of p53 and HMGA2 was negative in the vast majority(22/23,95.7%)of endometrial samples with normal morphology and benign lesions.HMGA2 was positive in only one"p53 signature"sample with normal morphology but positive p53,indicating that HMGA2 expression was abnormal in the very early stage of ESC.Conclusion:HMGA2 has abnormal expression in the very early stage of ESC.HMGA2 can be combined with p53 as a marker for early diagnosis of ESC,which can effectively improve the clinical diagnosis detection rate of EmGD and EIC and reduce the misdiagnosis rate,and has high clinical practical application value.HMGA2 is significantly associated with poor prognosis of ESC,and may be a molecular targeted therapeutic target for ESC.

关 键 词：HMGA2 P53 子宫内膜浆液性癌 EmGD 早期诊断 

分 类 号：R737.33[医药卫生—肿瘤]