pS2、Cath-D、PR和ER-α的表达与子宫内膜癌淋巴结转移关系的研究

Expression of pS2,Cathepsin D,PR,ER-α and Their Significance for Lymph Node Metastases in Endometrial Cancer

目的:观察子宫内膜癌组织中雌激素调节蛋白(pS2)、组织蛋白酶D(cath-D)、孕激素受体(PR)和雌激素受体-α(ER-α)的表达与淋巴结转移的关系。方法:应用免疫组织化学方法检测91例子宫内膜癌组织中pS2、cath-D、PR和ER-α表达。结果:91例子宫内膜癌组织中,18例(19.8%)患者出现淋巴结转移。pS2阳性表达、PR阳性表达与淋巴结转移呈负相关(P<0.05或P<0.01),cath-D阳性表达与淋巴结转移呈正相关(P<0.01),ER-α阳性表达与淋巴结转移无相关性(P>0.05)。多因素回归分析显示cath-D、PR为淋巴结转移独立的相关因素(均P<0.01)。pS2表达与ER-α、PR呈正相关(均P<0.01),而cath-D与ER-α、PR没有相关性(均P>0.05),pS2与cath-D亦无相关性(P>0.05)。淋巴结转移的患者5年累积生存率明显低于无淋巴结转移的患者(P<0.01)。结论:子宫内膜癌组织中pS2、PR阳性表达患者淋巴结转移率低,cath-D阳性表达患者有较高的淋巴结转移率。cath-D和PR为淋巴结转移独立的相关因素。

Objective： To determine the relationship between the expression of pS2, cath-D, PR, ER-α constitute independent prognostic factors and lymph node metastases in endometrial carcinoma. Methods： Immunohistochemistry was used to measure pS2, cath-D, PR, ER-α protein levels in endometrial carcinoma tissue of 91 patients. Results： Of the 91 patients, 18 （19.8%） had lymph node metastases. The positive expression of pS2 and PR were negatively correlated with lymph node metastases （P 〈 0,05 or P 〈 0.01 ）. The positive expression of cath-D was statistically correlated with lymph node metastases （P 〈 0.01）. The positive expression of ER-α was not statistically correlated with lymph node metastases （P 〈 0.01）. It was demonstrated that cath-D and ER-α were both independent factors of lymph node metastases （P 〈 0.01）. The expression of pS2 was statistically correlated with ER-α and PR （P 〈 0.01）. Cath-D has no correlation with ER-α and PR （P 〉 0.05）. There was no correlation between pS2 and cath-D （P 〉 0.05）. Five-year cumulative survival rate of patients with lymph node metastases was lower than that of patients without lymph node metastases （P 〈 0.01）. Conclusion： The endometrial carcinoma patients with negative expression of pS2 and PR had low lymph node metastases. The patients with positive expression of cath-D had a high- er possibility to have lymph node metastases. Cath-D and PR appeared to be powerful prognostic factor associated with lymph node metastases in endometrial carcinoma.