子宫内膜癌中p16甲基化、Her-2表达及血清CA125水平与临床病理特征的关系

Relationships between Methylation of p16 Gene,Her-2 Expression and Serum CA125 Level with Clinicopathological Characteristics in Endometrial Carcinoma

背景与目的:研究子宫内膜癌(endometrial carcinoma,EC)组织中抑癌基因p16的甲基化和癌基因Her-2的表达及血清肿瘤标志物CA125水平及其与临床病理特征间的关系。材料与方法:收集手术切除标本EC组织38例及内膜对照组织20例,采用甲基化特异性PCR法检测p16的甲基化状态;用免疫组化法检测Her-2蛋白的表达;对所有病例术前均采用免疫放射法测定血清CA125水平,并分析3者与临床病理特征之间的关系。结果:20例对照组织中p16的甲基化、Her-2表达、血清CA125均阴性(0/20),而38例EC组织中3者阳性率分别为57.9%(22/38)、60.5%(23/38)、23.7%(9/38),与对照组比较差异均有统计学意义(P均<0.05)。p16甲基化、Her-2表达的阳性率以及血清CA125阳性率均与EC临床分期有相关关系(P均<0.05),p16甲基化和血清CA125阳性率与病理分化有相关关系(P均<0.05),血清CA125水平与宫外淋巴结转移有关(P<0.05),3者与肿瘤浸润深度均显著相关(P均<0.05)。Spearman相关分析结果显示Her-2与CA125之间呈正相关关系(rs=0.323,P=0.048),与p16甲基化之间呈负相关关系(rs=-0.362,P=0.026)。结论:p16的甲基化、Her-2表达、血清CA125的阳性率反映了肿瘤不同阶段中各基因及肿瘤标志物的不同表现,联合检测对指导术后治疗具有一定的意义。

BACKGROUND AND AIM：To study the correlations between p16 gene methylation,Her-2 expression and serum CA125 level in endometrial carcinoma（EC）and clinicopathological characteristics.MATERIALS AND METHODS：A total of 38 EC tissues and 20 normal controls（NC）were analyzed.We studied the p16 gene methylation by methylation specific PCR（MSP）and Her-2 expression by Envision method,and the preoperative serum CA125 levels were checked by radio-immunity in all cases.The correlations of expression levels and EC clinicopathological characteristic were studied.RESULTS：The positive rates of p16 methylation,Her-2 expression and serum CA125 level were 57.9%（22/38）,60.5%（23/38）and 23.7%（9/38）,respectively,in 38 cases of EC,but were not detected in 20 normal controls,the difference was significant（P〈0.05）.Methylation of p16 gene,Her-2 expression and serum CA125 level were all statistically related to clinical stage of EC in test group（P〈0.05）,methylation of p16 gene and the level was statistically related to histological grade（P〈0.05）.Serum CA125 levels were statistically related to pelvic lymph node mestastasis（P〈0.05）,the 3 indexes were all statistically related to the depth of tumor invasion（P〈0.05）.Spearman correlation revealed there was a statistically positive relationship between Her-2 and serum CA125 level（P=0.048）and negative correlation between methylation of p16 gene and Her-2 expression（P=0.026）.CONCLUSION：The measurements of p16 methylation,Her-2 expression and serum CA125 level may reflect different behaviors of genes and tumor markers at different stages of tumor pathogenesis.They may be useful tools for providing information about the malignant degree,prognosis,and may guide postoperative treatment for patients with EC.