ER、PTEN在不同类型子宫内膜组织中的表达及意义

The expression and significarce of ER and PTEN in various endometriums

目的检测ER、PTEN在不同类型子宫内膜腺上皮细胞中的表达。方法采用免疫组化检测ER、PTEN的表达。结果⑴ER的表达在正常子宫内膜腺上皮细胞增生期显著高于分泌期(P<0.01)。增殖症中显著高于正常宫内膜(P<0.05),而内膜癌中明显低于增殖症和正常宫内膜(P<0.05)。在增殖症中单纯>复杂>不典(均P<0.05)。内膜样腺癌中<50岁和≥50岁年龄组、>12和≤12肌层浸润组和不同的手术病理分期间ER的表达均无显著性差异(P>0.05)。而在高、中和低分化程度之间均有显著性差异(均P<0.05);⑵PTEN的表达在增生期和分泌期无差异(P>0.05)。不典与单纯、不典与复杂相比均有显著性差异(均P<0.01)。内膜样腺癌中PTEN表达在<50岁和≥50岁组,不同分化程度的癌组织,不同肌层浸润深度和不同分期之间均无显著性差异(P>0.05);⑶ER、PTEN在不典型增生和子宫内膜样癌组织中表达均无相关性(r=0.315,r=0.422,P>0.05);结论⑴ER参与了正常宫内膜的变化,ER表达降低与内膜样癌的发生有一定关系,且ER表达减少与癌细胞恶性程度增加有关,故可以作为病理诊断的一项指标;⑵PTEN表达降低促使了癌前病变的发生,可能是引起内膜细胞癌变的机制之一,但是PTEN表达与临床病理学特征关系不大;⑶雌激素对PTEN的表达影响不大。

Objective To analyze the expression of ER and PTEN in the gland epithelial cells of various endometriums. Methods We apply immunohistochemistry technique to detect ER and PTEN. Results 1. In normal endometrium （NE）, ER expression in proliferative endometriurn （PE） are higher than that in secretory endometrittm （SE） （P 〈 0.01 ）. ER expression are different in various endometrittms, endometrial hyperplasia （EH） 〉 NE 〉 endometrioid adenocarcinoma （EAC） （P 〈 0.05）. There are some differences of ER expression in various histological toes of EH. Those are simple hyperplasia （SH） 〉 complex hyperplasia （CH） 〉 atypical hyperplasia（AH） （ P 〈 0.05）. ER expression are not correlated with ages, depth of myometrial invasion （DMI） and pathological stages （P 〉 0.05）, but ER expression are associated with histological grading （HG） ： well differential endometrioid adenocarcinoma （WDEA） 〉 moderate differential endometrioid adenocarcinoma （MDEA） 〉 low differential endometrioid adenocarcinoma （LDFA）. 2. The differences are not significant for the PTEN expression in PE and SE （ P 〉 0.05）. The differences are significant between AH and SH, and also between AH and CH （ P 〈 0.01 ）. In EAC, the differences of PI＇EN expression are not sighficant in different ages types, in different DMI groups, and also in different HG. 3. Our results shows no correlation betwwen and ER＇ expression in the epithelial cells of both All and EAC （ P 〉 0.05）. Conclusion 1. ER may have some functions in the NE and may put important effect in development of EAC. ER expression may provide important evidence for pathological diagnosis because it is correlated with HG. 2. Loss of PTEN expression are involved in the development of precancerous changes and EAC, but PTEN are not correlated with histopathlogical characters. 3. PTEN expression are no affected by estrogen.