TFF2、ERa和ERβ在子宫内膜癌中的表达及其临床意义

Expression and Clinical Significance of TFF2,ERa and ERβ in Endometrial Carcinoma

目的:研究三叶因子2(Trefoil factors2,TFF2)及雌激素受体ERa,ERβ在子宫内膜癌、子宫内膜不不典型增生及正常子宫内膜组织中的表达并探讨其临床意义。方法:应用免疫组化法对14例正常子宫内膜组织、22例子宫内膜不典型增生及82例子宫内膜癌病例中TFF2,ERa和ERβ的蛋白表达进行检测,观察在不同子宫内膜组织中TFF2,ERa和ERβ蛋白的表达情况。结果:TFF2在正常子宫内膜中的阳性表达率为85.7%(12/14),在不典型增生组织中的阳性表达率72.7%(16/22),在子宫内膜癌中的阳性表达率为57.3%(47/82),TFF2蛋白表达强度在正常、不典型增生和内膜癌组间比较有统计学差异(P<0.05)。TFF2蛋白表达与肿瘤的分化程度,肿瘤的分期和淋巴结转移有关(P<0.05),与浸润程度无关。ERa在正常子宫内膜中的阳性表达率为92.8%(13/14),在不典型增生组织中的阳性表达率为86.4%(19/22),在子宫内膜癌中的阳性表达率为53.7%(44/82),ERa蛋白表达强度在正常,不典型增生和内膜癌组间比较有统计学差异(P<0.05),ERa蛋白表达与肿瘤的分化程度和浸润程度有关(P<0.05),与肿瘤的分期和淋巴结转移无关。ERβ在14例正常子宫内膜组织中ERβ蛋白阳性表达率为78.6%(11/14),在子宫内膜不典型增生中的蛋白阳性表达率为72.7%(16/22),在82例子宫内膜癌组织中ERβ蛋白阳性表达率为48.8%(40/82),ERβ蛋白表达强度在正常、不典型增生和内膜癌组间比较有统计学差异(P<0.05),ERβ蛋白的表达与肿瘤的分化程度、浸润程度有关,与肿瘤的分期和淋巴结转移无关。结论:TFF2、ERa和ERβ在正常子宫内膜、子宫内膜不典型增生、子宫内膜癌中的表达逐渐降低,为进一步研究在子宫内膜癌诊治中的作用提供依据。

Objective： To investigate the expression levels of Trefoil factors2 （TFF2）, ERa and ERI3 in endometrial carcinoma, endometrial hyperplasia and normal endometrium respectively and elucidate the clinical significance of their alterations in expression. Methods： The immunohistochemical method （S.P） was used to detect the expression levels of TFF2, ERa and ERβ among 14 normal endometrium cases, 22 endometrial hyperplasia cases and 82 endometrial carcinoma cases. Results： 57.3%（47/82） positive TFF2 expression was observed in endometrial carcinoma, lower than that in endometriosis dysplasia （72.7 %, 16/22） and in normal endometrium （85.7 %,12/14） with a dramatical statistic significance （P〈0.05）. The expression level of TFF2 was related to histology grade, clinical stage and lymph node metastasis （P〈0.05）, but not with the myometrial invasion. The positive rate of ERa in endometrial carcinoma was 53.7%（44 /82 ）,while the rates were 86.4 %（19/22） and 92.8 %（ 13/14）respectively in endometriosis dysplasia and normal endometrium, suggesting a significant differential expression （P〈0.05）. The level of ERa had a deep relationship with histology grade and invasion degree, but nothing to do with the clinical stage and lymph node metastasis. The level of ERβ showed a similar change tendency in endometrial carcinoma, endometriosis dysplasia and normal endometrium with a rate 48.8 %, 72.7 %, 78.6 % respectively. Statistic analysis was performed （P〈0.05）. The expression level of ERβ was correlated with histology grade and invasion degree, but not with the clinical stage and lymph node metastasis. Conclusion： All the expression levels of TFF2, ERa, ERβ were gradually reduced in normal proliferative endometrium, endometriosis dysplasia and endometrial carcinoma. Positive TFF2 expression level was involved in the development of endometrial adenocarcinomas. Our research can provide better evidence to the mucosal protection effect of TFF2 and its clinical significance in the diagnosis of endometrial carcinoma, and identify a potential biological marker for the monitoring in the process of screening, follow-up and prognosis prediction.