细胞周期调控相关蛋白p14arf,p16ink4a和p53在子宫内膜癌组织中的表达及意义

The Expressions of Cell Cycle Regulatory Proteins p14arf,p16ink4a and p53 in Human Endometrial Carcinoma

目的探讨细胞周期调控相关蛋白p14arf,p16ink4a和p53在子宫内膜癌(EC)组织中表达情况。方法采用免疫组化S-P法,检测42例EC,36例正常子宫内膜组组织中p14arf、p16ink4a及p53的表达程度,并对比其差异,分析它们之间的关系。结果p14arf阳性表达率在子宫内膜癌与正常内膜组织中分别为73.81%(31/42)、100%(36/36),两组比较差异有统计学意义(P<0.01)。子宫内膜癌中p14arf表达缺失的比例高于正常子宫内膜;p14arf表达水平与病理分级、临床分期相关;与组织学类型和肌层浸润深度、淋巴结转移无关。p16阳性表达率在子宫内膜癌与正常内膜组织中分别为57.14%(24/42)、100%(36/36)、两组比较差异有统计学意义(P<0.01)。子宫内膜癌中p16ink4a表达缺失的比例高于正常子宫内膜;p16ink4a表达水平与临床分期、病理分级和淋巴结转移相关;与组织学类型和肌层浸润深度无关。p53阳性表达率在子宫内膜癌与正常增生内膜组织中分别为47.62%(20/42)、22.22%(8/36),两组比较差异有统计学意义(P<0.05),子宫内膜癌中p53阳性表达的比例高于正常子宫内膜;p53表达与临床分期、病理分级、盆腔淋巴结转移和肌层浸润深度相关,与组织学类型无关。在子宫内膜癌组织中p14arf与p53表达密切相关(P<0.01)。结论p14arf、p16ink4a和p53异常表达提示细胞的过度增殖和增殖-凋亡相关基因的表达失衡在子宫内膜恶性转化过程中起重要作用。其异常表达可作为子宫内膜增生性疾病不同发展阶段的诊断及预测其生物学行为的参考指标。

Objective To investigate the expressions of p14 gene, p16 gene and p53 gene in the endometrial carcinoma （EC）. Methods We determined the expression levels of p14arf,p16ink4a and p53 in 42 cases with endometrial carcinoma and 36 cases with normal endometrial by immunohistochemistry technique,and compared the differences and analyzed their relations. Results The positive rates of p14 in the EC and normal were 73.81% , 100% respectively. The differences in p14arf positive rate between the two groups had statistical significance （P 〈 0.01 ）. The expression deletion ratio in EC was higher than that in the normal endometria. The expression of p14aff was related to surgical stage, pathological grade, but was not related to the myometrial invasion, histological type （endometroid, non-endometroid）and pelvic lymph node metastasis. The positive rates of p16 protein were 57.14% , 100% . The difference in p16 positive rates between EC and the normal group had statistical significance （ P 〈 0.01 ）. The expression deletion ratio in EC was higher than that in the normal endometrimn. The expression of p16ink4a was related to surgical stage,pathological grade and pelvic lymph node metastasis,but was not related to the histological type （endometroid,non-endometroid） and myometrial invasion . The positive rates of p53 in the EC and the normal group were 47.62% , 22.22% respectively. The difference in p53 positive rate between the two groups had statistical significance （ P 〈 0.05 ）. The expression of p53 was related to the surgical stage, pathological grade, pelvic lymph node metastasis and myometrial invasion, but was not related to the histological type （ endometroid, non-endometroid）. The expressions of p14arf and p53 were intensively correlated ,Χ^2 = 11. 197, P = 0. 001. Conclusions The abnormal expressions of the three proteins may indicate that cell hyperproliferation and imbalance of proliferation-apoptosis gene expression may play an important role in the progression of endometrial careinogenesis. It can be used as markers to diagnose and foreeast the different development of endometrial hyperplasis.