子宫内膜癌中Maspin、uPA、ER、PR的表达及临床意义

Expression and clinical significance of Maspin,u PA,ER and PR in endometrial carcinoma

目的探讨子宫内膜癌中Maspin蛋白、u PA蛋白及雌激素受体(ER)、孕激素受体(PR)间表达的相关性及临床意义。方法对2004年6月至2014年6月病理科存档的蜡块,子宫内膜癌50例、不典型增生的子宫内膜50例及正常增殖期子宫内膜30例,采用免疫组化SP法,检测Maspin蛋白、u PA蛋白、ER、PR的表达情况,结合临床病理特征分析4种蛋白间表达的相关性。结果 Maspin蛋白、ER、PR在增殖期子宫内膜,不典型增生的子宫内膜,子宫内膜癌中阳性表达率逐渐降低,且组间比较有统计学意义(P<0.05),而u PA的阳性表达率逐渐升高(P<0.05)。Maspin、u PA、ER、PR的阳性表达率在手术病理分期、肌层浸润深度及有无淋巴结转移组中的差异均有统计学意义(P<0.05)。Maspin和ER、PR的表达呈一致性,Maspin与u PA呈负相关(r=-0.341,P<0.05),u PA和ER呈负相关(r=-0.293,P<0.05)。结论 ER、PR的减少,Maspin蛋白表达的缺失,伴随u PA蛋白表达上调,四者均参与了子宫内膜癌的发生、发展、浸润等过程,有可能成为判断子宫内膜癌治疗及预后的指标。

Objective To investigate the correlation of expressions of Maspin,urokinase-type plasminogen activator（ u PA）,estrogen receptor（ ER）,progesterone receptor（ PR） in endometrial tissue of patients with endometrial carcinoma,and to explore their clinical significance. Methods The pathological specimens preserved in our hospital from June 2004 to June 2014 were enrolled in the study,including 50 cases of endometrial carcinoma,50 cases of atypical endometrial hyperplasia and 30 cases of normal proliferative phase endometrium. The expression levels of Maspinprotein,u PA protein,ER,PR in these specimens were detected by immunohistochemisty（ SP）,and the correlation of expressions among the 4 factors was analyzed by combining with clinical and pathological characteristics. Results The positive expression rates of Maspin protein,ER,PR in proliferative endometrium,atypical hyperplasia endometrium,endometrial carcinoma were decreased gradually,and there were significant differences among the three groups（ P 〈0. 05）,however,the positive expression rates of u PA were increased gradually in the three kinds of tissues（ P 〈0. 05）. There were significant differences in the positive expression rates of Maspin,u PA,ER,PR among different operation pathological stage groups,different muscular layer infiltration depth groups,with or without lymph node metastasis groups（ P 〈0. 05）. The expression of Maspin was positively correlated to that of ER or PR,however,the expression of Maspin was negatively related with that of u PA（ r =- 0. 341,P 〈0. 05）,and the expression of u PA was negatively correlated to that of ER（ r =- 0. 293,P 〈0. 05）. Conclusion The reduction of ER and PR,lack of Maspin protein expression,with the up-regulation of u PA expression,are involved in the pathogenesis,development,infiltration process of endometrial carcinoma,which are possible to become the indexes for evaluating therapeutic effect and prognosis of endometrial carcinoma.