子宫内膜恶性病变组织中PTEN、CyclinE蛋白的表达及其临床意义

EXPRESSION AND CLINICAL SIGNIFICANCE OF PTEN,CyclinE PROTEIN IN ENDOMETRIAL MALIGNANT LESIONS

目的:探讨子宫内膜恶性病变中PTEN、CyclinE蛋白表达的相互关系及其临床意义。方法:采用免疫组化SP法检测正常子宫内膜、内膜增生、非典型性增生和子宫内膜样癌组织中PTEN和CyclinE蛋白的表达。结果:非典型性增生和子宫内膜样癌组中PTEN和CyclinE蛋白阳性表达率分别为55.0%与65.0%,40.0%和66.0%,两组中PTEN阳性表达均显著低于正常子宫内膜和子宫内膜增生组(P<0.01),而CyclinE则显著高于正常子宫内膜和子宫内膜增生组(P<0.001),且两者在非典型性增生和子宫内膜样癌组中的表达均呈中度负相关(r=-0.6637,P<0.02;r=-0.4481,CC<0.01)。子宫内膜样癌组中PTEN阳性表达缺失与组织学分级(P<0.02)、肌层浸润深度或伴有转移(P<0.03)及临床分期有关(P<0.03)。CyclinE的阳性表达率与组织学分级有关(P<0.02),与肌层浸润(P>0.05)和临床分期无关(P>0.05)。子宫内膜样癌组中肿瘤的复发分别与PTEN的低表达和CyclinE的高表达有关(P<0.05,P<0.02)。结论:PTEN表达缺失和CyclinE的过度表达与子宫内膜样癌的发生、发展和肿瘤的复发密切相关,二者的联合检测可作为子宫内膜样癌的早期诊断、评价肿瘤生物学行为和预后、指导临床治疗的生物学指标。

Objective：To investigate the relatlonship betweem PTEN and CyclinE protein expression and its clinical significance of endometrial benign and malignant lesions. Methods：The expression of PTEN and CyclinE proteins were tested by S-P immunohistochemistry on normal endometrium （30 cases）, endometrial hyperplasia（30 cases）, atypical hyperplasia（20 cases） and endometrioil carcinoma（50 cases）. Result：The positive expression rate of PTEN and CyclinE proteins in atypical hyperplasis and endometrioid carcinoma groups was 55.0%, 65.0%, 40.0% and 66.0%, respectively. The expression of PTEN positively in atypical hyperplasia and endometrioid carcinoma groups was significantly lower than these of normal endometrium and endometrial hyperplasia groups （P 〈 0.01 ）, but CyclinE protein was significantly higher than those of normal endometrium and endometrial hyperplasia groups （ P 〈0. 001）. The expression of PTEN protein was inversely correlated with CyclinE proteins expression in endometrial atypical hyperplasia and in endometrioid carcinoma groups（ r=-0. 663 7, P〈0.02; r=-0. 448 1, P 〈 0.01）. In endometrioid carcinoma the expression loss of PTEN protein positively was significantly associated with histological grade（ P 〈0.02）, muscles invasion or lymph node metastasis（ P 〈0.03） and clinical stage（ P 〈0.03）. The expression of CyclinE protein positively was correlated with histological grade（ P 〈0.02）, but not related to muscles invasion（ P 〉0.05）and clinical stage（ P 〉0.05）. The lower expression of PTEN and the higher expression of CyclinE were related with recurrence in endometrioid carcinoma （ P〈0.05, P 〈0.02）. Conclusion：The results suggest that the loss expression of PTEN and the overexpression of CyclinE protein are closely related to the generation, development and recurrence of medometrioid carcinoma. Binded detections of PTEN, CyclinE protein might be a useful biomarker in the early diagnosis, in predicting the biological behavior and prognosis of endometrioid carcinoma and in guiding clinical treatment.