端粒酶、MUC1和STAT6在不典型子宫内膜增生癌变过程中的表达

Expression and significance of immunohistochemical detection of telomerase,MUC1 and STAT6 in the cancerous process of atypical hyperplasia of endometrial

目的探讨不典型子宫内膜增生癌变过程中端粒酶、黏蛋白(MUCl)和信号转导、转录活化因子6(signal transducers and activators of transcription,STATs)免疫组化的表达规律及临床意义。方法收集手术及刮宫标本220例,其中正常子宫内膜40例,子宫内膜轻、中、重度不典型增生各40例,子宫内膜样腺癌60例。应用免疫组化检测方法,检测上述标本中端粒酶、MUC1和STAT6的表达情况,总结各组的表达规律及特点。结果端粒酶、MUC1和STAT6三者在子宫内膜样腺癌及重度不典型增生的表达均明显高于正常子宫内膜,差异有统计学意义(P<0.05);端粒酶和MUC1在子宫内膜样腺癌的表达明显高于轻度、中度不典型增生,差异有统计学意义(P<0.05);端粒酶在重度和轻度不典型增生两者之间表达差异具有统计学意义(P<0.05);但不同程度不典型增生及子宫内膜样腺癌中STAT6的表达两两对比差异无统计学意义(P>0.05);端粒酶、MUC1和STAT6在重度不典型增生和子宫内膜样腺癌中的表达差异均无统计学意义(P>0.05)。结论在同等程度的子宫内膜不典型增生中,端粒酶、MUC1和STAT6三者联合检测,表达阳性或者阳性程度进行性加强的病例可能提示其进展为更重的不典型增生乃至癌变的潜能更大,对临床早期诊断及预后判断有一定的指导意义。

Objective To investigate the immunohistochemical expression and its clinical significance of telomerase,MUC1 and STAT6 of atypical endometrial hyperplasia in carcinogenesis. Methods A total of the surgery and curettage specimens of 220 cases were collected. Among the 220 cases,40 cases were normal endometrium,endometrial mild,moderate and severe atypical hyperplasia was 40 cases,respectively,and 60 cases were uterus endometrioid carcinoma. Immunohistochemical detection method was used to detect the expression of telomerase,MUC1 and STAT6 in the samples. The expression rule and the characteristics of each group were summarized. Results The expressions of the telomerase,MUC1 and STAT6 in the samples of endometrial adenocarcinoma and atypical hyperplasia were significantly higher than that of the normal endometrium. There were significant differences（ P 〈0. 05）. The expressions of telomerase and MUC1 in the samples of endometrial adenocarcinoma were significantly higher than that of mild and moderate dysplasia. There were significant differences（ P 〈0. 05）. The difference in the expression of telomerase between the severe and mild atypical hyperplasia was statistically significant（ P 〈0. 05）. However,there was no difference in the expression of STAT6 between different atypical hyperplasia and endometrioid adenocarcinoma（ P 〈0. 05）. There was no difference in the expressions of telomerase,MUC1 and STAT6 between severe atypical hyperplasia and endometrioid adenocarcinoma（ P 〉0. 05）. Conclusion The positive expression or positive strengthening of the combination detection of telomerase,MUC1 and STAT6 in the same degree of endometrial hyperplasia indicate that there was a great potential of progression to more severe atypical hyperplasia and cancerization. It has certain guiding significance to the early clinical diagnosis and prognosis.