人附睾分泌蛋白4在子宫内膜癌组织中的表达及临床意义

Expression and Clinical Significance of Human Epididymis Secretory Protein 4 in Endometrial Carcinoma

目的:通过检测人附睾分泌蛋白4(HE4)在子宫内膜癌组织中的表达水平,观察HE4与不同临床及病理特征的相关性,探讨其在子宫内膜癌诊断、治疗及预后中的临床意义。方法:应用即用型免疫组织化学染色两步法对32例经病理学证实为子宫内膜癌的石蜡标本进行HE4检测。分析HE4表达与子宫内膜癌FIGO分期、病理类型、组织学分级、肌层侵犯深度、肿瘤的大小和年龄的关系等各组间的差异,分析其与子宫内膜癌临床病理特征的关系。结果:(1)HE4阳性颗粒主要定位在细胞膜和细胞质上,在32例子宫内膜癌组织中的HE4的阳性表达率较高,为87.5%。(2)HE4在组织学分级为高分化组的子宫内膜癌组织中的阳性表达率及强度均高于中低分化组(P<0.05)。(3)HE4蛋白在晚期子宫内膜癌组织中阳性表达率及表达强度均高于早期组(P<0.05)。(4)HE4蛋白在子宫内膜癌的阳性表达与年龄、病理分型、肌层侵犯深度及肿瘤大小均无关(P>0.05);但在HE4强阳性表达程度方面,深肌层浸润者强阳性表达(61.5%)多于无深肌层浸润者(36.8%),其直径≥2 cm的肿瘤强阳性表达(61.1%)高于直径<2 cm的肿瘤(28.6%),差异均有统计学意义(P<0.05)。结论:HE4基因的高表达与子宫内膜癌的侵袭、进展等方面关系密切,可以作为肿瘤侵袭进展的标志以及评估子宫内膜癌预后的一个重要指标。

Objective：Through the detection of human epididymis secretory protein 4（HE4） expression in endometrial carcinoma and correlation study of HE4 and different clinical and pathological features,explore the diagnosis of endometrial cancer,the clinical significance of the treatment and prognosis.Method：The paraffin embedded specimens of 32 cases of endometrial carcinoma were confirmed by pathological examination,they were detected by using the two step method of immunohistochemical staining for HE4.The relations of the expression of HE4 in endometrial carcinoma and FIGO staging,pathological type,histological grade,myometrial invasion,tumor size and age differences between groups were analyzed,and its relationship with clinicopathological features of endometrial carcinoma was analyzed.Result：（1）HE4 positive particles were mainly localized in the cell membrane and cytoplasm,and the positive expression rate of HE4 in 32 cases of endometrial carcinoma was higher,which was 87.5%.（2）The positive expression rate and intensity of HE4 in the endometrial carcinoma tissues of the high differentiation group were higher than those in the low and middle differentiation group（P〈0.05）.（3）The positive expression rate and the expression intensity of HE4 protein in advanced endometrial carcinoma were higher than those in the early stage（P〈0.05）.（4）The positive expression of HE4 protein in endometrial carcinoma was not related to the age,pathological type, depth of invasion and tumor size（P〉0.05）,but in the HE4 positive expression level,deep myometrial invasion strong positive expression（61.5%） than no deep myometrial invasion（36.8%）,the diameter of the tumor was greater than 2 cm strong positive expression（61.1%） is higher than the diameter 〈2 cm tumor（28.6%）,the differences were statistically significant（P〈0.05）.Conclusion：The high expression of HE4 gene is closely related with the invasion and progression of endometrial carcinoma,it can be used as a marker for the progression of tumor invasion and an important index of evaluating the prognosis of endometrial carcinoma.