卵巢高级别浆液性腺癌组织中叉头框转录因子M1和Gli-1蛋白表达的临床意义

Clinical significance of FOXM1 and Gli-1 protein expression in high-grade ovarian serous carcinoma

目的探讨卵巢高级别浆液性腺癌中叉头框转录因子M1（FOXM1）和Gli－l蛋白表达的变化规律及临床意义。方法采用免疫组化染色的方法检测94例卵巢高级别浆液性腺癌组织和20例正常输卵管组织中FOXM1和Gli－l蛋白的表达情况，并分析FOXM1和Gli－l蛋白的表达与患者临床病理特征和预后的关系。结果94例高级别浆液性腺癌组织中，FOXM1蛋白的阳性表达率为79.8%（75/94），Gli－l蛋白阳性表达率为77.7%（73/94），均明显高于正常输卵管组织（分别为5.0%和10.0%，均P〈0.05）。FOXM1和Gli－l蛋白在卵巢高级别浆液性腺癌中的表达与国际妇产科联盟（FIGO）分期有关，Ⅲ～Ⅳ期患者肿瘤组织中FOXM1和Gli－l蛋白的阳性表达率明显高于Ⅰ～Ⅱ期（均P〈0.001）。FOXM1和Gli－l蛋白在卵巢高级别浆液性腺癌组织中的表达呈明显的正相关关系。FOXM1和Gli－l阳性表达患者的5年的生存率分别为8.0%和6.8%，均明显低于阴性表达患者（分别为36.8%和38.1%，均P〈0.05）。Cox多因素分析表明，FOXM1蛋白表达和FIGO分期是影响卵巢高级别浆液性腺癌患者预后的独立因素（均P〈0.05）。 结论FOXM1和Gli－l蛋白过表达均参与了卵巢高级别浆液性腺癌的发生，并与FIGO分期有关。FOXM1和Gli－l蛋白在卵巢高级别浆液性腺癌中的表达呈正相关。FOXM1蛋白表达和FIGO分期是影响卵巢高级别浆液性腺癌患者预后的独立因素。

Objective To investigate the different expression and prognostic significance of forkhead box M 1 （FOXM1） and Gli-I in ovarian high grade serous carcinoma （HGSC）. Methods The expressions of FOXM1 and Gli-1 in 94 cases of HGSC and 20 cases of normal fallopian tube tissues were detected by immunohistochemistry. Kaplan-Meier analysis and Cox muhivariate survival analysis were used to assess the relationship of the FOXM1 and Gli-1 levels with age, International Federation of Gynecology and Obstetrics （FICO） stage, omental metastasis, and residual loci and prognosis of HGSC. Results The positive rates of FOXMI and Gli-1 expression in HGSC were 79.8% （75/94） and 77.7% （73/94） , respectively, both significantly higher than those of the normal controls （P〈0.05）. The expressions of FOXM1 and Cli-1 were significantly correlated with FIGO stage, and both of their positive rates in stage Ⅲ- Ⅳ patients were significantly higher than those in stage Ⅰ- Ⅱ cases （P〈0.001）. The expressions of FOXM1 in HGSC were positively correlated with C, li-1. Kaplan-Meier analysis revealed that the 5-year overall survival rates of FOXM1- and Gli-1-positive groups were 8.0% and 6.8%, significantly lower than 36.8% and 38.1% of the FOXM 1- and Gli-1-negative groups, respectively （P 〈 0.05 for both）. Cox multivariate survival analysis revealed that FIGO stage and overexpression of FOXM1 protein were independent prognostic factors of HGSC patients （P〈O.05 for both）. Conclusions The overexpression of FOXM1 and Gli-1 proteins participate in the carcinogenesis of HGSC, and are significantly associated with FIGO stage. The protein expression of FOXM1 is positively correlated with Gli-1 in HGSC. Expression of FOXM1 protein and FIGO stage are independent prognostic factors of HGSC.