脆性组氨酸三联体与半胱氨酸蛋白酶3在子宫内膜癌组织中的表达

Expression of fragile histidine triad and caspase-3 in tissue of endometrial carcinoma

目的探讨脆性组氨酸三联体（FHIT）和半胱氨酸蛋白酶3（caspase-3）蛋白在子宫内膜腺癌发生、发展过程中的可能作用。方法选择子宫内膜腺癌患者（腺癌组，60例）、子宫内膜不典型增生患者（不典型增生组，30例）和子宫肌瘤切除术患者（对照组，正常子宫内膜30例）作为研究对象。采用免疫组织化学（免疫组化）SP法检测3组中FHIT、caspase-3蛋白的表达，结合临床病理特征进行分析。结果FHIT在腺癌组、不典型增生组和对照组的阳性表达率分别为53．3％（32／60）、63．3％（19／30）和100％（30／30），caspase-3的阳性表达率分别为51．7％（31／60）、70．0％（21／30）和86．7％（26／30），腺癌组FHIT、caspase-3的阳性表达率明显低于对照组，差异均有统计学意义（均P〈0．01）。FHIT与caspase-3的阳性表达均与子宫内膜腺癌的组织分级（G1、G2～3）有关（X^2=9．312、14．299，均P〈0．01），FHIT还与子宫内膜腺癌的手术-病理分期（Ⅰ-Ⅱ、Ⅲ-Ⅳ）、肌层浸润（≤1／2、〉1／2）和淋巴转移（阴性、阳性）有关（均P〈0．05）。结论FHIT和caspase-3可能与子宫内膜腺癌的发生均有关。FHIT和CASPASE-3联合检测有利于子宫内膜腺癌的早期诊断及判断预后。

Objective To detect the expression of the fragile histidine triad （FHIT） and easpase-3 protein in endometrial adenocarcinoma （ EC ）, endometrial atypical hyperplasia （ EIN ） and the normal endometrium. To explore the relation between FHIT and easpase-3 in the genesis and progression of endometrial carcinoma. Methods The expression of FHIT and caspase-3 protein in 60 cases of EC, 30 cases of EIN and 30 cases of normal endometrial tissue were detected by streptavidin-peroxidase （ SP ） immunohistochemical staining. The clinicopathological characteristics of patients and the relevance of FHIT and caspase-3 were analyzed. Results The positive rates of FHIT in EC, EIN and normal endometrium were 5313% （32/60） , 63.3% （19/30） and 100.0% （30/30） , respectively. The positive rates of easpase-3 in EC and EIN and normal endometrium were 51.7% （31/ 60）, 70.0% （21/30）, 86. 7% （26/30）, respectively. The positive rates of FHIT and caspase-3 in EC were significantly lower than those in normal endometrium, the difference was statistically significant （ P 〈 0. 01 ）. The positive expressions of FHIT and caspase-3 were all related to the organizational grade of EC （ G1 ： X^2 = 9. 312, G2-3 ： X2 = 14. 299, all P 〈 0.01 ）. The positive expressions of FHIT was associated with the surgical-pathologic staging of EC （ Ⅰ - Ⅱ , Ⅲ -1W ）, myometrial invasion （ ~〈 1/2, 〉 1/2 ） and lymph node metastasis （ negative, positive） （ all P 〈 0. 05 ）. Conclusions FHIT and caspase-3 may be associated with the occurrence of endometrial adenocarcinoma. The combined detection of FHIT and caspase-3 protein may become important indexes of early diagnosis and forecasting of EC.