CA125和ki67在子宫腺肌病患者中的表达及其临床意义

Significance of expression of ki67 and CA125 in adenomyosis

目的观察子宫腺肌病患者癌抗原125(CA125)水平和子宫内膜细胞增生相关核抗原ki67的表达情况,探讨子宫腺肌病受子宫内膜增殖能力的影响情况。方法将70例经手术切除子宫病例纳入研究,包括38例子宫肌瘤,32例子宫腺肌病。检测子宫肌瘤和子宫腺肌病患者CA125和ki67在子宫腺肌病病灶、内膜中的表达,比较增生期病例与分泌期病例、在位内膜腺体与异位内膜腺体的CA125水平和ki67表达强度。结果与肌瘤组相比,腺肌病组患者血清CA125水平明显更高,差异有统计学意义(P<0.001),对两组患者血清CA125在增生期和分泌期的水平进行比较,差异无显著性(P=0.174;P=0.811)。对腺肌病组和肌瘤组内膜的血清CA125水平表达,以及腺肌病组在位内膜腺上皮与异位内膜腺上皮的血清CA125水平进行比较,差异无统计学意义,且无周期性改变(P>0.05)。与分泌期相比,两组患者增生期内在位内膜腺体ki67表达强度明显更强,差异有统计学意义(P<0.001,P<0.001),其中腺肌病组异位内膜腺体表达ki67变化未表现出周期化;与自身在位内膜相比,腺肌病组异位内膜腺体分泌期内表达ki67明显更强,差异有统计学意义(P<0.001);对肌瘤组患者和腺肌病组患者子宫内膜ki67的表达进行比较,差异无统计学意义(P>0.05)。结论腺肌病组患者的血清CA125水平明显比肌瘤组患者高;腺肌病异位内膜ki67表达增多明显增强且程度较在位内膜高,即子宫肌层受子宫内膜入侵后,增殖能力增强,在疾病的发展有明确意义。

Objective To explore the reason and clinical significance of uterus cancer antigen 125（ CA125） in adenomyosis and to investigate the expression of ki67 in the pathogensis of adenomyosis uturus. To study the effect of endometrial proliferation on incidence of adenomyosis.Methods 70 cases with surgical removal of the uterus were chosen into research,including 38 cases of uterine fibroids and 32 cases of uterine adenomyosis. Immunohistochemical staining was used to detect the expression of CA125 and ki67 in eutopic endometrium from women with leiomyoma and eutopic and ectopic endometrium of adenomyosis. We used chemiluminescent enzyme immunometri assay to determine serum CA125 levels. To compared the expression of CA125 and ki67 between proliferative and secretory phase,glandular cell in ectopic endometrium and that of eutopic endometrium. Results The median serum CA125 level in adenomyosis group was significant higher than serum CA125 level in leiomyoma group,with statistically significant difference（ P〈0. 001）. But difference between the proliferative and secretory phase showed no siginificance（ P = 0. 174,P = 0. 811）. The CA125 staining intensity of glandular cell in ectopic endometrium of adenomyosis was similar to that of eutopic endometrium,with no cyclic change（ P〉0. 05）. The ki67 staining intensity of glandular cells in the endometrium of the two groups in the proliferative phase were stronger than secretory phase,with statistically significant difference（ P〈0. 001,P〈0. 001）,but difference between two groups showed no statistical significance（ P〉0. 05）. Ectopic endometrium showed no cyclic change,and there was stronger staining intensity in glandular cells than that of eutopic endometrium in luteal phase（ P〈0. 001）. Conclusion The median serum CA125 level of adenomyosis was significantly higher than that of leiomyoma. Compared with that of eutopic endometrium,the ki67 staining intensity of ectopic endometrium was stronger,the proliferative activity of the endometrium may show significant effects on the development of the adenomyosis after the invasion into the myometrium.