子宫内膜癌中端粒酶逆转录酶与p53、拓朴异构酶Ⅱα、激素受体、凋亡小体的检测及相关性

Detection of human telomerase reverse transcriptase,p53,topoisomerase Ⅱα,hormone receptors and apoptosis and their correlation in endometrial adenocarcinoma

目的观察端粒酶逆转录酶（hTERT）、p53、拓朴异构酶（TP）Ⅱα、激素受体（ER、PR）、凋亡小体在子宫内膜癌中表达情况,探讨上述因子在子宫内膜癌发生、发展中的作用及其相互关系。方法收集上海市长宁区中心医院2000-2006年全子宫切除标本54例,其中子宫内膜癌44例,子宫内膜增生反应10例。免疫组化SP法检测子宫内膜癌、子宫内膜增生反应病例中hTERT、p53、TPⅡα、ER、PR的表达情况,并对其染色强度作定量分析。HE切片中观察凋亡小体,高倍镜下计数凋亡小体及TPⅡα阳性细胞。结果hTERT、p53、TPⅡα、凋亡小体在子宫内膜癌中均有表达,并随着肿瘤组织学分级的增加而表达增强（P〈0.05）,而在子宫内膜增生反应中上述标志物不表达或仅有微弱表达。ER、PR在子宫内膜增生反应中表达广泛,但在内膜癌组织中表达下降,而且恶性程度越高其表达越少（P〈0.05）。子宫内膜癌中hTERT表达与p53、TPⅡα、凋亡小体表达成正相关（P〈0.01）;p53表达与凋亡小体表达成正相关,而与ER、PR表达为负相关（P〈0.05）。结论子宫内膜癌中hTERT、p53与细胞凋亡、增殖以及肿瘤恶性程度等密切相关,表明细胞周期失调节在子宫内膜癌发生发展中具有重要作用。

Purpose To observe the expression of hTERT, p53, TPIIa, hormone receptors and apoptotic bodies in endometrial carcinoma, and to explore their significance and correlation in endometrial carcinogenesis. Methods A total of 54 cases of endometrial tissues from hysterectomy including 44 cases of endometrial carcinoma and 10 cases of endometrial proliferative reaction were obtained from Central Hospital of Changning District, Shanghai between 2000 and 2006. S-P immunohistocbemistry was used to detect positive staining areas of hTERT, p53, TP H a and hormone receptors in endometrial carcinoma and endometrial proliferative reaction. The apoptotic bodies were observed in HE section. Counting the number of apoptotic bodies and TP H apositive cells were conducted under a × 400 magnification. Results hTERT, 1953, TP H apositive cells and apoptotic bodies were all detected in endometrial carcinoma and their expression gradually increased with tumor grading（ P 〈 0.05 ）. In contrast, the above markers were not expressed or slightly expressed in endometrial proliferative reaction. ER and PR were widely expressed in endometrial proliferative reaction while gradually decreased with the increase of malignant degree（ P 〈 0.05 ）. In endometrial carcinoma hTERT was positively correlated with p53 ,TP Ⅱ aand apoptotic bodies（ P 〈 0. 01 ）. Expression of p53 showed positive correlation with apoptotic body and negative correlation with ER and PR （P 〈 0. 05 ）. Conclusious hTERT and p53 are closely related with cell apoptosis, proliferation and malignant degree in endometrial carcinomas, which indicates that cell cycle deregulation may play an important role in endometrial carcinogenesis.