中期因子蛋白表达与子宫内膜腺癌进展的关系

Relationship between midkine protein expression and the progression of endometrial adenocarcinoma

目的探讨中期因子(midkineMK)蛋白在子宫内膜腺癌中的表达和进展的关系。方法采用免疫组织化学EnVision法检测72例子宫内膜腺癌组织、15例子宫内膜非典型增生和20例正常子宫内膜组织中MK蛋白的表达情况,并结合患者临床及病理资料进行分析。结果子宫内膜腺癌、子宫内膜非典型增生、正常子宫内膜组织中MK蛋白阳性表达率分别为63.9%、33.3%、15.0%,子宫内膜腺癌中MK蛋白阳性率明显高于子宫内膜非典型增生(P<0.01)和正常子宫内膜(P<0.01)。随着肌层浸润深度、TNM分期的增加,MK蛋白的阳性率显著上升(P<0.01、P<0.05);有淋巴结转移组MK阳性率明显高于无淋巴结转移组(P<0.05);MK蛋白阳性的患者总的生存率低于阴性者(P<0.05)。结论MK蛋白在子宫内膜腺癌恶性进程中表达上调,有望成为子宫内膜腺癌恶性度评估和判断预后的有价值指标。

Objective To investigate the expression of midkine（MK） protein and its correlation with the progression of endometrial adenocarcinoma. Methods Immunohistochemical staining（EnVision）was used to detect the expression of MK protein in 72 cases of endometrial adenocarcinoma, 15 cases of uterine atypical endometrial hyperplasia and 20 cases of normal endometrium. Results The expression rates of MK protein in endometrial adenocareinoma, uterine atypical endometrial hyperplasia and normal endometrium were 63.9%, 33.3% and 15.0% respectively. The positive rate of MK protein in endometrial adenocarcinoma was higher than that in uterine atypical endometrial hyperplasia（ P 〈 0.01 ）and normal endometrium（ P 〈 0.01 ）. With the increasing of myometrium invasion depth and TNM grade, the positive rate of MK protein expression increased（ P 〈 0.01, P 〈 0.05）. The expression rate of MK protein in lymph node metastatic group was higher than those without metastasis（ P 〈 0.05）. The overall survival rates in patients with MK protein positive were lower than those in patients with MK protein negative（ P 〈 0.05）. Conclusion The expression rates of MK protein is increased during the malignant progresion in endometrial adenocarcinoma. It might be valuable index to evaluate the degree of malignancy and prognosis of patients in endometrial adenocarcinoma.