子宫颈腺癌与子宫内膜腺癌的组化及免疫组化观察

Histochemical and immunohistochemical expression in uterine cervix and endometrial adenocarcinoma

目的：探讨组化染色及免疫组化在宫颈腺癌与宫内膜腺癌诊断价值及临床意义。方法：采用组化染色及免疫组化Ｓ－Ｐ方法对宫颈腺癌及宫内膜腺癌的粘蛋白含量、分布及免疫组化阳性物的表达进行观察。结果：宫颈腺癌以含丰富的唾液酸粘蛋白为主，而子宫内膜腺癌以硫酸粘蛋白为主。波形蛋白（ｖｉｍｅｎｔｉｎ）在宫内膜腺癌阳性表达率６８．９％，而宫颈腺癌大多呈阴性表达，雌激素受体（ＥＲ）表达在宫内膜腺癌达６０．９％，而宫颈腺癌仅１９．６％，两者均差异有显著性（Ｐ＜０．０５）。而抑癌基因ｐ５３和癌基因ｃ－ｅｒｂＢ－２阳性率与癌肿的分级和预后有关。结果：粘蛋白组化染色及ｖｉｍｅｎｔｉｎ可帮助鉴别诊断宫颈腺癌及宫内膜腺癌，而ＥＲ、ｐ５３。

Purpose To investigate the significance of histochemical and immunohistochemical detection of cervix and endometrial adenocarcinoma. Methods The expressions of AB/PAS (pH 2 5, pH 1 0) and vimentin, ER, p53, c erbB 2 in the uterine cervix and endometrial adenocarcinoma were studied by histochemical and immunohistochemical techniques. Results There were a large amount of salivary acid mucin in the adenocarcinoma of the uterine cervix and a large amount of sulfomucin in endomecarcinoma. The positivity rates of vimentin in endometrical adenocarcinoma were 68 9% and were significantly higher than those in the adenocarcinoma of the uterine cervix ( P <0 05). The positivity rates 60 9% of ER in endometrial adenocarcinoma were significantly higher than those in the adenocarcinoma of the uterine cervix ( P <0 05). The p53 and c erbB 2 expressions in carcinoma were correlated with histological grade and prognosis. Conclusion Histochemical method and vimentin have great values in the differential diagnosis between the adenocarcinoma of uterine cervix and endometrium. The positivity rates of the ER, p53, c erbB 2 are correlated with the patients prognosis.