抑癌基因PTEN在子宫内膜癌中的表达及其临床意义

Expression and clinical signification of PTEN tumor suppressor gene in endometrial cancers

目的探讨抑癌基因PTEN在子宫内膜癌发生、发展过程中所起的作用，分析抑癌基因PTEN在子宫内膜癌中与某些临床病理学参数之间的关系。方法采用链霉抗生物素蛋白一过氧化物酶免疫组织化学法分别检测抑癌基因PTEN蛋白在15例正常子宫内膜、15例子宫内膜癌前病变、40例原发性子宫内膜癌各组织标本中的表达情况。结果①抑癌基因PTEN在正常子宫内膜组织中的表达率最高，为93．3％（14／15）；在癌前病变组织中表达率有所下降，为66．7％（10／15）；而在癌组织中表达率最低，为45．0％（18／40），3者比较有统计学意义（P〈0．05）。②抑癌基因PTEN表达与子宫内膜癌的组织学类型有关，腺癌表达率（37．1％）明显低于其他类型子宫内膜癌的表达率（100％），2者相比差异有统计学意义（P〈0．05）。③抑癌基因PTEN表达与临床分期、肌层浸润深度、病理分化程度、淋巴结转移无关（P〉0．05）。④本研究对40例子宫内膜癌患者术后情况进行了随访，抑癌基因PTEN阳性表达者的病死率（5．6％）明显低于阴性表达者（40.9％），2者差异有统计学意义（P〈0．05）。随访5年以上18例，比较抑癌基因PTEN阳性与阴性表达者的5年生存率，阳性表达者5年生存率（100％）明显高于阴性表达者（50．0％）（P〈0．05）。结论抑癌基因PTEN在子宫内膜癌发生过程中起到重要作用，抑癌基因PTEN失表达与肿瘤的组织学类型有关。抑癌基因PTEN表达与临床分期、肌层浸润深度、病理学分级、淋巴结转移等临床病理学参数之间无明显相关性。抑癌基因PTEN表达与子宫内膜癌患者的预后有关。

Objective To discuss the role of PTEN in the carcinogenesis and development of ndometrial cancers （EC）, and to observe the correlation between PTEN protein expression and the clinical or pathological features in EC, Methods PTEN protein expression was detected in 15 normal human endometrium tissues, 15 precancer tissues and 40 primary EC tissues respectively by immuno histochemical method （ SP method）. Results PTEN protein expression were found in 14 of 15 （93.3%） normal endometrium, 10 of 15 （66.7%） precancers and 18 of 40 （ 45.0% ） EC. The difference of PTEN protein concentration among the three groups was statistically significant（P〈0.05）. PTEN protein expression varies according to tumors types. The expression in endometrial adenocarcinomas （37.1%） was much lower than in other types of EC （P〈0.05）. In contrast, no significant differences of PTEN protein expression were observed in FIGO stage, pathologic grade, myometrial invasion and lymph node metastatic. All 40 EC patients were followed up after operation. 10 patients of them died. The mortality in PTEN positive stain （ 5. 6% ） was significant lower than in PTEN negative stain （40. 9% ） （ P 〈 0. 05 ）. Conclusion The PTEN protein expression in different endometrium tissues is important for the pathogenesis of ECs, and the loss of PTEN function due to the mutational or other mechanisms is possibly the earliest event in the pathogenesis of endometrial adenocarcinoma. Moreover, PTEN expression is related to the prognosis of EC.