细胞角蛋白在子宫内膜癌淋巴结中的表达及意义  

Expression of cytokeratin in lymphnodes of cases with endometrial cancer and its significance.

作　　者：刘风华[1] 王沂峰 王静[3] 薛强[3] 马玉燕[4] 江森[4] 

机构地区：[1]中山大学第二附属医院妇产科,广州510120 [2]广州市第二人民医院妇产科 [3]济南市第四人民医院病理科 [4]山东大学齐鲁医院妇产科

出　　处：《现代妇产科进展》2004年第2期110-113,共4页Progress in Obstetrics and Gynecology

摘　　要：目的 :研究细胞角蛋白 (cytokeratin ,CK)在子宫内膜癌淋巴结中的表达及其意义。方法 :采用免疫组化SP法检测 5 0例子宫内膜癌患者的淋巴结 2 98枚中CK的表达。结果 :(1)在转移淋巴结中 ,CK皆呈强阳性表达 ,其阳性表达率为 10 0 %。在Ⅰ、Ⅱ、Ⅲc期无转移淋巴结中 ,CK皆呈弱阳性表达 ,其阳性表达率分别为 14 .5 %、15 .1%和 16 .4 % ,3期差异无显著性 (P >0 .0 5 ) ;(2 )Ⅰ、Ⅱ期病例的淋巴结中CK表达在肌层浸润深度、组织学类型、组织学分级 3组的组内差异无显著性 (P >0 .0 5 ) ;而淋巴管浸润组的组内差异有显著性 (P <0 .0 5 ) ;(3)Ⅰ、Ⅱ期病例的淋巴结中CK表达及其他预后因素与肿瘤复发的关系 ,淋巴结中CK表达、淋巴管浸润、术后治疗 3组的组内差异有显著性 (P <0 .0 5 ) ,而肌层浸润深度、组织学类型、组织学分级 3组的组内差异无显著性 (P >0 .0 5 ) ;(4 )对子宫内膜癌的诸预后因素如肌层浸润深度、组织学类型、组织学分级、淋巴结中CK表达、淋巴管浸润、术后治疗等进行多元回归分析 ,结果显示 :淋巴结中CK表达是Ⅰ、Ⅱ期子宫内膜癌患者复发的唯一相关因素。结论 :在无转移淋巴结中 ,CK表达与淋巴管浸润有关 ,提示可能存在淋巴结微转移 ,是Ⅰ。Objective:To study the expression of cytokeratin(CK) in lymph nodes of cases with endometrial cancer and its significance.Method:The expressions of CK in 298 lymph nodes from 50 patients with endometrial cancers were analysed by immunohistochmical methods.Results:(1)The expressions of CK in lymph nodes with metastasis were all strong positive with a 100% positive rate.In lymph nodes without metastasis from stageⅠ,Ⅱ,Ⅲc cases,the expressions of CK were all weak and the positive expression rates of CK were respectively 14.5%,15.1%,16.4%, which had no significant difference(P>0.05).(2)Regard to the relation of depth of myometrial invasion,histological type,histological grade,lymph-vascular space involvement and CK expression in lymph nodes in stageⅠ,Ⅱ cases,CK expression in lymph nodes had no significant difference within the three groups of depth of myometrial invasion, histological type and histological grade(P>0.05),whereas had a significant difference within the group of lymph-vascular space involvement(P<0.05).(3)With respect to the relationship between the tumor recurrence and the expression of CK as well as other prognostic factors in patients with stageⅠ,Ⅱ disease,there was a significant difference within the three groups of CK expression in lymph nodes,lymph-vascular space involvement and postoperative therapy(P<0.05),but had no significant difference within the three groups of depth of myometrial invasion,histological type and histological grade(P>0.05).(4)Multiple regression analysis was conducted on many prognostic factors in stageⅠ,Ⅱ endometrial cancer.The results revealed that CK expression in lymph nodes was one and only relative factor.Conclusion:CK expression in lymph nodes without metastasis that relates to lymph-vascular space involvement probably predict lymph node micrometastasis and is an independent risk factor for recurrence of disease in stageⅠ,Ⅱ endometrial cancers.

关 键 词：细胞角蛋白 子宫内膜肿瘤 淋巴结微转移:预后 

分 类 号：R737.33[医药卫生—肿瘤]