ER、PR和p53蛋白在子宫浆液性乳头状癌和子宫内膜样癌鉴别诊断中应用的价值

Application value of ER,PR and p53 protein in differential diagnosis of uterine papillary serous carcinoma and uterine endometrioid carcinoma

目的:探讨ER、PR和p53蛋白在子宫浆液性乳头状癌(uterine papillary serous carcinoma,UPSC)和子宫内膜样癌(uterine endometrioid carcinoma,UEC)鉴别诊断中应用的价值,同时观察两种肿瘤生物学行为的差异。方法:回顾性分析9例UPSC(研究组)和同时期的117例UEC(对照组)患者的临床资料,比较两组的临床病理特点和免疫组化表达。结果:研究组平均年龄明显大于对照组,在肿瘤分期、组织分级、肌层浸润深度方面,研究组均较对照组严重,而5年生存率比较研究组明显小于对照组,以上差异均有统计学意义(P<0.05);免疫组化表达方面,研究组p53表达呈阳性者显著多于对照组,而ER(雌激素受体)和PR(孕激素受体)呈阳性表达者则显著少于对照组,差异均有统计学意义(P<0.05)。结论:UPSC是一种高度恶性的肿瘤,与UEC比较,具有p53高表达而缺乏ER和PR的特点,有助于两者的鉴别诊断。

Objective：To explore the application values of ER, PR and p53 protein in differential diagnosis of uterine papillary serous carcinoma （UPSC） and uterine endometrioid carcinoma （UEC）, and observe the differences of biological behaviors between the two kinds of tumors.Methods：Clinical data of 9 cases with UPSC （study group） and 117 cases with UEC （control group） were analyzed retrospectively, the clinical pathological characteristics and immunohistochemical expression were compared between the two groups.Results：The average age of study group was significantly higher than that of control group, the tumor stages, histological grades and depth of myometrial invasion in study group were more serious than those in control group, while the 5-year survival rate in study group was significantly lower than that in control group, there was significant difference in the above indexes between the two groups （P0.05）; the positive rate of p53 expression in study group was significantly higher than that in control group, but the positive rates of estrogen receptor （ER） and progesterone receptor （PR） were significantly lower than those in control group （P0.05）. Conclusion：Compared with UEC, UPSC is a kind of highly malignant tumors with the characteristics of high expression of p53 and lack of ER and PR expression, which can be used for differential diagnosis.