摘要
目的 通过分析错配修复(mismatch repair, MMR)蛋白与ER、PR及p53在子宫内膜癌中的表达情况,探讨其临床病理意义及其对预后的影响。方法 收集2017年1月至2020年10月在十堰市太和医院确诊的226例子宫内膜癌患者的临床病理资料,采用免疫组织化学法对肿瘤组织进行MMR蛋白、ER、PR及p53检测,分析其表达与临床病理的关系及其对患者预后的影响。结果 226例子宫内膜癌组织中MMR蛋白的缺失率为18.6%(42/226),ER及PR的阴性表达率分别为6.6%(15/226)、11.9%(27/226),p53突变型表达率为59.7%(135/226)。MMR蛋白缺失在肿瘤分级、肌层浸润深度、淋巴脉管浸润(LVSI)及术后辅助治疗中差异具有统计学意义(P<0.05)。p53突变型表达多为非子宫内膜样腺癌,且多为高级别子宫内膜癌(P<0.05)。ER与PR的表达呈正相关,ER阴性表达与组织学类型、肿瘤分级、术后辅助治疗相关(P<0.01),而PR阴性表达还与国际妇产科联盟(FIGO)分期、LVSI及淋巴结转移有关(P<0.05)。p53突变型在ER阴性且PR阴性的子宫内膜癌中表达率高(P<0.05)。结论 MMR、ER、PR和p53蛋白的表达与子宫内膜癌的病变程度相关,在ER和PR阴性表达时,MMR蛋白缺失和p53突变型表达率高提示预后不良,可以通过监测免疫组化结果进行术前手术范围的选择、术后预后的判断并予以辅助治疗。
Objective To analyze the expression of mismatch repair(MMR) protein, ER,PR and p53 in endometrial carcinoma, and to explore its clinicopathological significance and its effect on prognosis. Methods The clinicopathological data of 226 patients with endometrial carcinoma diagnosed in Shiyan Taihe Hospital from January 2017 to October 2020 were collected. MMR protein, ER, PR and p53 in tumor tissues were detected by immunohistochemical method, and the relationship between protein expression and clinicopathology was analyzed. Results The deletion rate of MMR protein in endometrial carcinoma was 18.6%(42/226). The negative expression rates of ER and PR were 6.6%(15/226)and 11.9%(27/226), respectively, and the expression rate of p53 mutant was 59.7%(135/226). MMR protein deletion had statistical differences in tumor grade, depth of myometrial invasion, lymph-vascular space invasion(LVSI) and postoperative adjuvant therapy. The expression of p53 mutant was mostly non-endometrioid adenocarcinoma and most of them were high-grade endometrial carcinoma(P<0.05).There was a positive correlation between the expression of ER and PR. ER-negative expression is correlated with histological type, tumor grade, and postoperative adjuvant therapy(P<0.01), while the negative expression of PR was also significantly different in international federation of gynecology and obstetrics(FIGO) stage, LVSI and lymph node metastasis. The expression rate of p53 mutant in endometrial carcinoma with ER-negative and PR-negative expression was high and there was statistical difference(P<0.05). Conclusions The expression of MMR, ER, PR and p53 protein is related to the pathological degree of endometrial carcinoma. When ER and PR are negatively expressed, the MMR protein deletion and p53 mutant expression rate are high, suggesting a poor prognosis. so preoperative surgical range selection, postoperative prognosis judgment and adjuvant treatment can be performed by monitoring the results of immunohistochemistry.
作者
黄银银
方彩云
柏诗玉
龚坤雪
赵锐
李肖肖
王云
陈修文
HUANG Yinyin;FANG Caiyun;BAI Shiyu;GONG Kunxue;ZHAO Rui;LI Xiaoxiao;WANG Yun;CHEN Xiuwen(Union Training Base,Shiyan Taihe Hospital,Jinzhou Medical University,Shiyan 442000,Hubei,China;Department of Gynecology,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,Hubei,China;Department of Pathology,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,Hubei,China)
出处
《中国性科学》
2023年第2期72-76,共5页
Chinese Journal of Human Sexuality
基金
十堰市科学技术局引导性科研项目(21Y27)。
