C-erbB2蛋白和雌、孕激素受体与卵巢癌预后的关系

C-erbB2 protein,estrogen receptor and progesterone receptor in primary ovarian cancer: correlation with prognosis parameters and survival

[目的]探讨原癌基因C-erbB2、雌激素受体和孕激素受体与卵巢癌预后的关系。[方法]应用免疫组化LSAB法检测原癌基因C-erbB2蛋白、雌激素受体和孕激素受体在卵巢上皮性良性、交界性和恶性肿瘤中的表达,探讨其与卵巢癌预后的关系。[结果]恶性卵巢上皮性肿瘤与良性卵巢上皮性肿瘤之间,C-erbB2蛋白的强阳性表达差异有显著性意义(P<0.05),雌激素受体(ER)的阳性表达有显著性差异(P<0.05),孕激素受体(PR)的阳性表达有显著性差异(P<0.05)。在恶性程度较高,组织分化差,晚期的卵巢癌中C-erbB2蛋白的强阳性表达率高,其预后差;在组织分化好的卵巢癌中PR的表达率高,其预后好;ER与卵巢癌的临床分期、病理分级及预后均无关。三者联合检测时C-erbB2蛋白无过度表达和雌、孕激素受体均阳性的卵巢癌患者的5年生存率(71.4%)最高,而C-erbB2蛋白过度表达和雌、孕激素受体均阴性的卵巢癌患者的5年生存率(0.0%)最低,二者有显著性差异(P<0.05)。[结论]C-erbB2蛋白无过度表达和ER、PR均阳性的卵巢癌患者的生存率(71.4%)显著高于C-erbB2蛋白过度表达和ER、PR均阴性的卵巢癌患者的生存率(0.0%)(P<0.05)。三者联合检测对卵巢癌患者预后的估计及临床治疗的选择有一定的指导意义。

[ Objective] To determine the prevalence of C - erbB2 protein, estrogen receptor（ER） and progesterone receptor （PR） in epithelial ovarian carcinoma in our hospital and to analyze the correlation between the expression of C - erbB2 protein, ER and PR and prognosis parameters of the primary ovarian cancer. [ Methods] The three parameters above were studied by immunohistochemistry in paraffin- embedded tumor tissues from patients with benign （10）, borderline malignant （10） and malignant ovarian carcinoma（30）. [Results] The results were showed as follows：① The over- expression of C - erbB2 protein was 0.0% in benign ovarian tumors, 10.0% in borderline and 16.7% in malignant ovarian tumors of the primary ovarian cancer. The percentage of tumors with C - erbB2 over-expression was higher in those with stage Ⅱ- Ⅳ disease （25.0%） compared with those with stage I disease （0.0%） （P〈0.05） ,in patients with grade 3（33.3%）higher than those with grade 1 -2（5.6%）（P 〈 0.05）,but patients with over-expression of C - erbB2 protein had a poor prognosis. ② ER and PR were highly correlated with each other, while there was no correlation between C - erbB2 protein and steroid hormone receptors. ER and PR content differed significantly between benign （10.0%, both） and malignant ovarian tumors （70.0%, 63.3%, respectively） and showed no correlation with clinical stage. PR was found more often in highly differentiated malignant tumor （88.9 % ） than in poorly differentiated ones （25.0 % ） （ P 〈 0.05） . No such difference was found for ER. Expression of ER was still associated with improved survival, although this did not retain statistical significance （ P 〈 0.1）. Survival of patients With epithelial ovarian cancer was significantly prolonged by tumors expression of PR （ P 〈 0.05）. [ Conclusions] The survival of patients（71.4% ） with steroid receptor positive tumors without C - erbB2 over - expression was significantly prolonged（P 〈 0.05）. The combined detection of C- erbB2 protein, ER and PR will confer the information to predict the prognosis of patients with epithelial ovarian cancer and to select an appropriate hormonal therapy.