子宫内膜癌发生过程中自噬活性改变的初步探讨

Primary research in the change of the autophage activity in carcinogenesis and development of endometrioid adenocarcinoma.

目的:探讨正常子宫内膜、子宫内膜增生以及子宫内膜腺癌中自噬活性的变化。方法:收集2004年1月至2005年3月行子宫切除或诊断性刮宫的组织标本135例,其中正常子宫内膜43例,子宫内膜单纯性增生及复合性增生27例,子宫内膜不典型增生26例,子宫内膜腺癌39例。用免疫组化法检测全部组织中的Cathepsin-D和Rab7的表达。结果:(1)Cathepsin-D表达在正常子宫内膜增生期明显高于分泌期(0.244±0.091 vs 0.141±0.071,P<0.05);Rab7表达呈同一趋势(0.197±0.084 vs 0.114±0.060,P<0.05);(2)子宫内膜单纯性、复合性增生组的Cathepsin-D表达明显高于子宫内膜不典型增生组,子宫内膜腺癌细胞中Cathepsin-D表达则明显减弱(0.561±0.168 vs0.311±0.089 vs 0.055±0.044,P<0.001);Rab7的表达呈现与Cathepsin-D同一趋势(0.508±0.152 vs 0.281±0.076 vs 0.026±0.019,P<0.001)。结论:正常增生期子宫内膜细胞的自噬活性比分泌期子宫内膜细胞明显增强,子宫内膜增生的自噬活性比正常子宫内膜强,而子宫内膜腺癌细胞自噬活性明显减弱,提示自噬活性的改变可能参与了子宫内膜样腺癌的发生。

Objective：To evaluate the change and the clinical meanings ol the autophage activity of both normal and abnormal endometrium. Methods：A total of 135 specimens from hysterectomy and diagnostic curettage between January 2004 and March 2005 in Women＇s Hospital, School of Medicine, Zhejiang University were retrospectively analysed. There were 43 cases of normal endometrium,27 cases of simple and complex hyperplasia endometrium,26 cases of atypical hyperplasia endometrium, and 39 cases endometrioid adenocarcinoma. Immunohistochemistry method was used to exam the Cathepsin-D and Rab7 expression in these specimens. Results： （ 1 ） The expression of Cathepsin-D was significantly higher in the proliferative endometria than that in secretory endometria （0. 244 ±0. 091 vs 0. 141 ±0. 071 P 〈0.05）. The expression of Rab7 presented the same trend（0. 197 ±0. 084 vs 0. 114 ±0. 060,P 〈0. 05 ）. （2） The expression of Cathepsin-D in simple or complex hyperplasia was obviously higher than that in the atypical hyperplasia,but were significantly lower in the adenocarcinoma（0. 561 ±0. 168 vs 0. 311 ±0. 089 vs 0. 055 ± 0. 044 P 〈 0. 001 ）. The expression of Rab7 presented the same trend （0. 508 ±0. 152 vs 0. 281 ±0. 076 vs 0. 026 ±0. 019 P 〈0. 001 ）. Conclusions：The autophage activity in normal proliferative endometrium is obviously stronger than that in normal secretory endometrium. The autophage activity was lower in atypical hyperplasia than that in simple or complex hyperplasia, and is the lowest in the adenocarcinoma. The change of autophage activity may attend the occurring of endometrium adenocarcinoma.