子宫内膜样腺癌组织中错配修复蛋白和p53蛋白表达与临床病理特征的关系

Relationship between the expression of mismatch repair protein and p53 protein with clinicopathological features in endometrial adenocarcinoma tissues

目的分析子宫内膜样腺癌(EA)组织中错配修复蛋白(MMRP)和p53蛋白表达与临床病理特征的关系以及两者的相关性。方法本研究中的所有标本取自2017年1月～2018年12月在中南大学湘雅医院确诊并进行手术治疗的EA患者。应用免疫组化Envision法检测162例EA患者中MMRP及p53蛋白的表达情况;将4种MMRP中的1种以上表达缺失定为微卫星不稳定组(MSI组),全部阳性表达设为微卫星稳定组(MSS组)。分析MMRP与p53的表达与临床病理特征的相关性以及两种蛋白之间的相关性。结果 162例中,MSS组120例,MSI组42例。MSH2、MSH6、MLH1及PMS2的表达缺失率分别为3.7%、6.2%、10.5%及17.9%;其中共同缺失表达类型为MSH2-MSH6和MLH1-PMS2者分别为4例(2.5%)、15例(9.3%)。MMRP表达情况在分化程度、浸润深度方面比较,差异有统计学意义(P<0.05)。p53表达在年龄、分化程度、浸润深度、淋巴结转移方面比较,差异有统计学意义(P<0.05)。经Spearman分析得出,MSI与p53成正相关(r=0.189,P<0.05)。结论在EA患者中存在MMRP缺失,且MLH1、PMS2缺失表达较MSH2和MSH6多见。MSI及p53与EA的临床病理特征关系密切,对EA的预测以及恶性程度的评估具有参考价值,且两者成正相关,可能参与EA的发生、发展过程。

Objective To analyze the relationship between the expression of mismatch repair protein(MMRP)and p53 protein in endometrial adenocarcinoma(EA)tissues and the clinicopathological characteristics and the correlation between the two proteins.Methods All specimens in this study were taken from patients who were diagnosed with EA and underwent surgical treatment at Xiangya Hospital of Central South University from January 2017 to December 2018.The expression of MMRP and p53 protein in EA(162 cases)was detected by immumohistochemistry method Envision.The microsatellite instability group(MSI group)was defined as the expression deficiency of more than one of the four MMRPS,and the microsatellite stability group(MSS group)was defined as all four kinds of MMRP positive expression.The correlation between the expression of MMRP and p53 and clinicopathological features and the correlation between the two proteins were analyzed.Results There were 120 cases in MSS group and 42 cases in MSI group in 162 cases.The expression deletion rate of MSH2,MSH6,MLH1 and PMS2 was 3.7%,6.2%,10.5%and 17.9%respectively.Among them,4 cases(2.5%)and 15 cases(9.3%)had the common co-deletion expression types of MSH2/MSH6 and MLH1/PMS2 respectively.There were statistical differences in the expression of MSI in the degree of differentiation,depth of infiltration(P<0.05).There were statistical differences in the clinicopathological characteristics of EA patients'p53,such as age,differentiation degree,infiltration depth and lymph node metastasis(P<0.05).Spearman correlation analysis showed that there was a obvious positive correlation between MSI and p53(r=0.189,P<0.05).Conclusion There is MMRP deficiency in patients with EA,and the expression deficiency in MLH1 and PMS2 is higher than that of MSH2 and MSH6.MSI and p53 are closely related to the clinicopathological characteristics of EA,and have reference value for the prediction of EA and the evaluation of malignancy degree.MSI and p53 protein are positively correlated,which may be involved in the occurrence and development of EA.