Ki-67和CDK5预警子宫内膜非典型增生患者术后病理进展的价值  

The predictive value of Ki-67 and CDK5 in the pathological progression of patients with atypical endometrial hyperplasia

作　　者：杜亦琛 徐嘉莉 王芬芬[2,3] Du Yichen;Xu Jiali;Wang Fenfen(Shaoxing Maternity and Child Health Care Hospital,Shaoxing 312000;Women's Hospital,Zhejiang University School of Medicine,Hangzhou 310006;Zhejiang Provinical Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases,Zhejiang Province Clinical Research Center for Obstetrics and Gynecology,Zhejiang Provinical Key Laboratory of Traditional Chinese Medicine for Reproductive Health Research,Hangzhou 310006)

机构地区：[1]绍兴市妇幼保健院,绍兴312000 [2]浙江大学医学院附属妇产科医院,杭州310006 [3]浙江省妇科重大疾病精准诊治研究重点实验室、浙江省妇产疾病临床研究中心、浙江省生育健康研究中医药重点实验室,杭州310006

出　　处：《现代妇产科进展》2025年第2期103-106,112,共5页Progress in Obstetrics and Gynecology

基　　金：浙江省中医药管理局共建科技计划项目(No:GZY-ZJ-KJ-24083);浙江省教育厅一般项目(No:Y202045696)。

摘　　要：目的:探讨子宫内膜Ki-67和CDK5表达与子宫内膜非典型增生患者术后病理进展的关系,寻找预警子宫内膜非典型患者术后病理升级的新方法。方法:收集2019年6月至2022年7月在浙江大学医学院附属妇产科医院术前诊断子宫内膜非典型增生行全子宫切除标本,按最终病理诊断分为子宫内膜非典型增生组(54例)和子宫内膜样腺癌组(90例)。免疫组化EnVision法检测两组CDK5和Ki-67表达情况,分析CDK5和Ki-67表达与术后病理升级子宫内膜样腺癌的关系。结果:CDK5和Ki-67各自高表达时子宫内膜非典型增生患者发生术后病理进展的OR值分别为[11.333(95%CI为3.285~39.101)、3.604(95%CI为1.705~7.621),P均<0.05]。CDK5和Ki-67共同低表达时发生术后病理进展的OR值为[0.148(95%CI为0.070~0.314),P<0.05],而CDK5和Ki-67共同高表达时发生术后病理进展的OR值为[14.183(95%CI为1.840~109.307),P<0.05],且Ki-67和CDK5两者间表达并不存在相关(P>0.05)。结论:Ki-67和CDK5表达与子宫内膜非典型增生患者术后病理进展风险有关,Ki-67、CDK5联合检测可能有助于预警子宫内膜非典型增生患者术后病理升级风险。Objective:To investigate the correlation between Ki-67 and CDK5 expression and pathological advancement in individuals diagnosed with atypical endometrial hyperplasia,and to explore novel approaches for predicting postoperative pathological progression in this patient population.Method:Tissue samples were obtained from endometrial specimens that had undergone hysterectomy as a treatment for endometrial atypical hyperplasia in the Women's Hospital,Zhejiang University School of Medicine from June 2019 to July 2022.Based on the final pathological diagnosis,there were two groups:the endometrial atypical hyperplasia group(54 cases)and the endometrial adenocarcinoma group(90 cases).The EnVision method was used to detect the expressions of CDK5 and Ki-67 between the two groups,and the correlation between their expression changes and pathological progression of endometrial adenocarcinoma was analyzed.Results:The OR for postoperative pathological progression in patients with atypical endometrial hyperplasia with positive expressions of CDK5 and Ki-67 were[11.333(95%CI 3.285~39.101),3.604(95%CI 1.705~7.621),respectively,both P<0.05].The ORs for postoperative pathological progression in patients with co-low expressions of CDK5 and Ki-67 were[0.148(95%CI 0.070~0.314),P<0.05].The OR for postoperative pathological progression occurring with co-high expression of CDK5 and Ki-67 was[14.183(95%CI 1.840~109.307),P<0.05].There was no correlation between Ki-67 and CDK5 expressions(P>0.05).Conclusion:The expression levels of Ki-67 and CDK5 were associated with the pathological progression risk of patients with atypical endometrial hyperplasia.The combined detection of Ki-67 and CDK5 may be helpful in predicting the risk of postoperative pathological escalation in patients with endometrial dysplasia.

关 键 词：KI-67 CDK5 子宫内膜非典型增生 术后病理进展 术后预警 

分 类 号：R711.7[医药卫生—妇产科学]