子宫内膜癌中ER、PR、MK、VEGF的表达及与病理特征的关系

STUDY OF THE EXPRESSIONS OF ER,PR,MK,VEGF AND THE RELATIONSHIPS WITH CLINICOPATHOLOGIC FEATURES IN ENDOMETRIAL CARCINOMA

目的探讨子宫内膜癌中雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、中期因子(midkine,MK)、血管内皮生成因子(vascular endothelial growth tactor,VEGF)的表达及其与临床病理特征的关系。方法分别采用免疫组织化学法和实时荧光定量PCR检测50例子宫内膜腺癌(研究组)和30例正常子宫内膜组织(对照组)中ER、PR、MK、VEGF蛋白和mRNA的表达水平,结合患者的临床病理资料进行分析。结果①与正常子宫内膜组织相比,子宫内膜癌组织中ER和PR蛋白阳性表达率下降(P<0.05),MK和VEGF蛋白的阳性表达率明显升高(P<0.05)。②子宫内膜组织中ER和PR mRNA表达量分别为0.67±0.39、1.01±0.54,较正常对照组(2.68±0.24、2.57±0.49)低,差异有统计学意义(P<0.05)。MK和VEGF mRNA表达量分别为9.77±2.08、29.85±6.72,明显高于正常对照组(P<0.05)。③在子宫内膜癌组织中检测指标的表达水平与临床病理分期、组织学分级和肌层浸润深度有关系,随临床病理分期、组织学分级的升高和肌层浸润的加深,ER、PR的表达水平下降,而MK和VEGF表达水平明显升高,差异均有统计学意义(P<0.05,P<0.01)。结论 ER、PR、MK和VEGF的检测有助于评估子宫内膜癌的生物学行为和预后,并指导该疾病的内分泌治疗。

Objective To explore the expressions of estrogen receptor （ER）, progesterone receptor （PR）, midkine （MK）, vascular endothelial growth factor （VEGF） and the relationships with elinieopathologie features in endometrial carcinoma. Methods Immunohistoehemistry and real - time fluorescence quantitative PCR （ FQ - PCR） were used to detect the expression of ER, PR, MK and VEGF in 50 cases of endometrial adenocarcinoma and 30 cases of normal endometfium. Results （1）The expression of ER and PR protein were significantly lower in endometrial carcinoma than that in normal endometrium（ P 〈0.05） , howerever, MK and VEGF increased in endometrial carcinoma（ P 〈0.05）. （2） The expression of ER and PR mRNA significantly decreased in endometrial carcinoma tissues compared with that in the normal endometrium tissue （0.67 ± 0.39 vs 2.68 ± 0.24, P 〈0.05 ; 1.01 ± 0. 54 vs 2.57 ± 0.49, P 〈 0.05）. The expression of MK and VEGF mRNA in endometrial carcinoma were respectively 9.77 ± 2.08 and 29.85 ± 6.72, and that in the normal endometrium tissue were 1.24 ± 0.36 and 11.49 ± 1.72, the former was significantly higher than the latter （ P 〈 0.05 ）. （3）The expression level of these parameters were related to clinical stages, histological grades and the depth of myometrial invasion. With the increasing of clinical stages, histological grades and the depth of myometrial invasion, the expression of ER and PR mRNA decreased, and the expression of MK and VEGF increased, there were significant differences（ P 〈 0.05, P 〈 0.05 ） . Conclusion The Detections for ER, PR, MK and VEGF may be benefit for evaluating biological behaviors and prognosis of patients with endometrial adenocarcinoma, and also have significance for clinical endocrine therapy.