bcl-2、ER、PR在子宫内膜癌组织中的表达及其意义

The Expression of bcl-2,Estrogen and Progestogen Receptors in the Tissue of Uterine Endometrial Carcinoma

目的:探讨bcl-2、雌激素受体(ER)及孕激素受体(PR)在不同类型子宫内膜组织中的表达及其与子宫内膜癌的发生、发展的关系。方法:采用免疫组织化学方法(SP法)检测55例子宫内膜癌组、13例不典型内膜增生组及11例正常子宫内膜组(对照组)的bcl-2、雌激素受体及孕激素受体的水平,行光学显微镜观察结果,进行阳性平均百分率计算,并行统计学处理。结果:bcl-2阳性表达在正常子宫内膜组最多,其阳性表达率为96.1%,不典型内膜增生组阳性表达率为78.1%,子宫内膜癌组阳性表达率为56.9%,3组比较,差异有显著性(P<0.05);雌激素阳性表达在正常子宫内膜组最多,其阳性表达率为66.1%,不典型内膜增生组阳性表达率为34.8%,子宫内膜癌组阳性表达率为20.9%,3组比较,差异有显著性(P<0.05);孕激素阳性表达在正常子宫内膜组最多,其阳性表达率为89.4%,不典型内膜增生组阳性表达率为70.9%,子宫内膜癌组阳性表达率为64.3%,3组比较,差异有显著性(P<0.05)。结论:bcl-2表达减少可能是子宫内膜癌发生过程中的早期事件。雌激素是子宫内膜癌危险因素并随病理分级的升高雌激素受体的表达逐渐减少。孕激素与雌激素相反,延缓子宫内膜癌发生与发展。

Objective：to investigate the correlation of expression levels of bcl-2 protein and recep- tors for estrogen and progestogen with the occurrence and development of uterine endothelial carcinoma to provide the clues for early diagnosis and prognosis prediction of uterine endometrial carcinoma. Methods：55 cases of uterine endometrial carcinoma and 13 cases of atypical hyperplasia of uterine endothelia were selected in our study. 11 cases of normal uterine endometria in hyperplasia phase obtained by diagnostic dilatation and curettage of other reasons were used as the control group. All the carcinoma samples selected in this study were adenocarcinoma. Immunohistochemistry was used to study the expression of bcl-2, as well as estrogen and progestogen receptors,followed by observation under light microscopy and statistical analysis of the data. Results. bcl-2 protein had its highest expression in control group（100 %）, and the lowest expression in malignant group（47. 2%）. The expression rate of bcl-2 in the atypical hyperplasia group was between the above two,which was 76. 9%. There were statistic differences（P〈0. 05） among the three groups. The estrogen receptor had the highest expression in the group of endometrial carcinoma（100%）but the lowest one in the normal control（45.5%）. The expression of estrogen receptor in the group of atypical hyperplasia was 76. 9%. There were statistic differences among the three groups（P〈0.05）. The progestogen receptors were most highly expressed in normal control group （100 % ）, less expressed in atypical hyperplasia（69.2 % ）, and the least expressed in endometrial carcinoma（36.4%）. There were statistic differences among the three groups （P〈0.05）. Conclusion：Decreased expression of bcl-2 might be one of early events during the occurrence of endometrial carcinoma. Estrogen is one of the risk factors of uterine endometrial carcinoma but its expression decreases steadily as the histopathological ranking of the disease goes up. In contrary, progestogen may play an inhibitory role in the occurrence and development of uterine endometrial carcinoma.