雌、孕激素受体在子宫内膜腺癌中的表达及其意义

Expression of ER、PR in Endometrioid Adenocarcinoma and its Significance

目的研究雌激素受体(ER)、孕激素受体(PR)在子宫内膜腺癌组织中的表达及其临床意义。方法采用免疫组织化学S-P法测定84例子宫内膜腺癌组织中ER、PR的表达。结果子宫内膜腺癌组织中ER、PR阳性表达率分别为58.3%、65.5%。ER、PR阳性表达率与手术病理分期无关(P>0.05),而与组织学分级密切相关。G1级者ER、PR阳性表达率(74.4%、83.7%)显著高于G2级(55.6%、59.3%)(P<0.01)和G3级(14.3%、21.4%)者(P<0.05)。子宫肌层浸润深度≤1/2者中ER、PR阳性表达率分别为69.8%、77.4%,>1/2者阳性表达率为38.7%、45.2%,两者中ER、PR阳性表达率比较均有显著性差异(P<0.05)。无淋巴结转移的子宫内膜腺癌组织中ER、PR阳性表达率(59.4%、71.6%)分别与有淋巴结转移组织中ER、PR阳性表达率(50.0%、20.0%)进行比较,2者比较PR阳性表达率有显著性差异(P<0.05),而ER的表达无显著性差异(P>0.05)。结论ER、PR的异常表达可能在子宫内膜腺癌的发生、发展过程中起着重要作用,对分析子宫内膜腺癌的预后和指导临床内分泌治疗均有重要意义。

Objective To investigate the expression of the estrogen receptor（ER）,progesterone receptor（PR） in endometriold adenocarcinoma and its clinical significance. Methods The expression of ER、PR in 84 cases of endometrioid adenocarcinoma was detected with the S-P immunohistochemical method. Results The positive expression rates of ER、PR in the endometriold adenocarcinoma were 58.3 % ,65.5 %, respectively. The positive rates of ER and PR were significantly related with histological grade, but not related with clinicopathologic stages（P〈 0.05）. The positive expression rates of ER,PR were higher in G1 grade（well differentiated） endometrioid adenocarcinoma（74.4% ,83.7% ）than in G2 grade（medium differentiated）（55.6% ,59.3 % ） （P 〈 0.01 ） or in G3 grade （poorly differentiated） （14.3% ,21.4% ）（P〈0.05）. The expression rates of ER、PR were significantly higher in cases with myometrial invasion depth ≤ 1/2 （69.8 %, 77.4 % ） than in cases with myometrial invasion ≤ 1/2 （38.7 %, 45.2 % ） （ P 〈 0.05）. Positive expression rat6s of ER,PR were 59.4% ,71.6% in cases without lymph nodes metastases,and 50.0% ,20.0% in cases with lymph nodes metastases,showing a significant difference in the positive expression of PR （P 〈 0.05）, but not in the positive expression of ER （P 〉0.05）. Conclusion The abnormal expression of ER, PR plays an important role in the carcinogenesis and development of endometrioid adenocarcinoma. The detection of both ER and PR is important for prognosis and the treatment of endometrioid adenocarcinoma.