G蛋白偶联雌激素受体在子宫内膜腺癌组织表达及其意义

Expression of G protein-coupled estrogen receptor in endometrial adenocarcinoma.

目的探讨G蛋白偶联雌激素受体(GPER)在子宫内膜腺癌组织中发生发展的作用。方法选取2005年3月至2008年4月郑州大学第一附属医院病理科手术及活检标本的存档蜡块,采用免疫组织化学SP法检测55例子宫内膜腺癌、49例子宫内膜增殖症及10例正常增生期子宫内膜组织中GPER蛋白的表达,分析其与子宫内膜腺癌患者临床病理特征的关系。结果正常增生期子宫内膜组织、子宫内膜增殖症组织和子宫内膜腺癌组织中GPER蛋白的阳性表达率分别为20.0%、67.3%和81.8%,差异具有统计学意义(χ2=15.778,P<0.001)。子宫内膜增殖症中,简单型增生、复杂型增生及不典型增生内膜组织中GPER蛋白的阳性表达率分别为30.0%、70.0%和84.2%,差异具有统计学意义(χ2=8.864,P=0.012)。绝经后和未绝经子宫内膜腺癌组织中GPER的阳性表达率分别为89.7%和62.5%,差异具有统计学意义(χ2=3.977,P=0.046)。高分化和中、低分化子宫内膜腺癌组织中GPER的阳性表达率分别为71.4%和100%,差异具有统计学意义(χ2=5.196,P=0.023)。临床分期Ⅰ期和(Ⅱ+Ⅲ)期子宫内膜腺癌组织中GPER的阳性表达率分别为73.0%和100%,差异具有统计学意义(χ2=4.268,P=0.039)。有淋巴结转移和无淋巴结转移的子宫内膜腺癌组织中GPER的阳性表达率分别为66.7%和83.7%,差异无统计学意义(χ2=0.210,P=0.646)。在肌层浸润深度<1/2和≥1/2的子宫内膜腺癌组织中GPER的阳性表达率分别为75%和100%,差异无统计学意义(χ2=3.057,P=0.080)。结论 GPER与子宫内膜腺癌的发生、发展可能具有相关性。

Objective To investigate the expression and significance of GPER protein in endometrial adenocarcinoma. Methods Archival specimens from surgery of biopsy reserved at the pathology department, the First Affiliated Hospital From 2005 March to 2008 April, were selected for the study. The expression of GPER was detected by immunohistochem- istry in 10 cases of proliferative phase endometrium, 49 cases of endometrial hyperplasia and 55 cases of endometrial ade- nocarcinoma. Results The positive rates of GPER in proliferative endometrium, endometrial hyperplasia and endometri- al adenocarcinoma tissues were 20. 0% （2/10） , 67. 3% （33/49） and 81.8% （45/55） respectively,The differences a- mong the three groups were significant （X^2 = 15. 778, P 〈 0. 001 ）. The positive rates of GPER in simple hyperplasia, complex hyperplasia and atypical hyperplasia tissue were 30. 0% （3/7） ,70. 0% （14/20） and 84. 2% （16/19） respec- tively. The differences among the three groups were significant （X^2 = 8. 864, P = 0. 012）. In endometrial adenocarcino- ma, the positive rates of GPER in FIGO staging （ Ⅱ＋ Ⅲ ） was significant higher thanⅠ （ X^2 = 4. 268, P = 0. 039 ） ; the positive rates of GPEH in medium and low differentiation（ G2 ＋ G3 ） was significant higher than high differentiation （G1） （X2 = 5. 196, P = 0. 023 ） ;the positive rates of GPER in menopause was significant higher than postmenopause （X^2 = 3. 977 ,P = 0. 046）. No obvious relationship between GPER and lymph node metastasis, estrogen receptor status or depth of myometrial invasion was found （P = 0. 646;P = 0. 080）. Conclusion GPER may participate in the carcinogenesis and development of endometrial adenocarcinoma.