子宫内膜癌组织PTEN和c-erbB-2蛋白表达临床意义的探讨

Expressions of PTEN and c-erbB-2 protein in endometrial carcinoma tissues and their clinical significance

目的:探讨抑癌基因PTEN和癌基因c-erbB-2蛋白在子宫内膜癌组织中表达及其与临床病理特征的关系。方法:采用免疫组化法检测52例子宫内膜癌组织、29例子宫内膜不典型增生和18例正常子宫内膜组织中c-erbB-2及PTEN蛋白的表达,并分析其与临床特征的相关性。结果:子宫内膜癌组织中PTEN表达缺失率明显高于子宫内膜不典型增生和正常子宫内膜,P<0.001;PTEN表达缺失与不典型增生的严重程度、病理分级相关(P<0.05),但与肌层浸润深度和淋巴结转移无关(P>0.05)。子宫内膜癌组织中c-erbB-2的阳性表达率明显高于正常子宫内膜和子宫内膜不典型增生,P<0.05;c-erbB-2阳性表达与子宫内膜癌的病理分级、临床分期、肌层浸润深度和淋巴转移相关(P<0.05),但与不典型增生的程度无关(P>0.05)。在子宫内膜癌组织中PTEN的表达缺失率与c-erbB-2的过度表达呈正相关。结论:PTEN蛋白的表达缺失与子宫内膜癌的发生有关;c-erbB-2蛋白的高表达提示预后不良;PTEN和c-erbB-2联合检测可作为筛选复发转移高危因素的标志。

OBJECTIVE： To investigate the tumor suppressor gene PTEN and oncogene c-erbB-2 proteins in endometrial cancer and the correlation with the clinical characteristics and pathology. METHODS： The expressions of c-erbB-2 and PTEN proteins of 52 cases of endometrial cancer, 29 cases of endometrial atypical hyperplasia and 18 cases of normal endometrial tissues were detected by immunohistochemical methods, and the clinical relevance was analyzed. RESULTS： The expression loss rate of PTEN was significantly higher in endometrial cancer than that in endometrial atypical hyperplasia and normal endometrium （P〈0. 001）, and correlated with the severity of atypical hyperplasia and the pathological grade （P〈0.05）, but the depth of myometrial invasion and lymph node was not significant correlaed with it （P〈0.05）. The positive expression rate of c-erbB-2 was significantly higher in the endometrial cancer than that in the normal endometrium and endometrial atypical hyperplasia （P〈0.05）, the expression of c-erbB-2 was correlated with the pathologic grade, clinical stage, and the depth of myometrial invasion and lymph node （P〈 0.05）, but not with the degree of proliferation （P〈0.05）. The expression loss rate of PTEN in endometrial cancer tissue was positively correlated with the over-expression of c-erbB-2. CONCLUSIONS： PTEN protein expression loss plays an important role in the development process of endometrial atypical hyperplasia to endometrial cancer; the overexpression of c-erbB-2 protein suggests a poor prognosis. PTEN and c-erbB-2 joint detection may screen some patients with the existence risk factors of recurrence and transfer to provide a basis for choice of the program of treatment.