IMP3、Ki-67、P53、Bcl-2在不同子宫平滑肌肿瘤中的表达

Expression of IMP3, KI-67, P53, BCL-2 in Different Uterine Smooth Muscle Tumors

目的探讨IMP3、Ki-67、P53、Bcl-2在子宫平滑肌肿瘤中的表达及意义。方法采用免疫组化法检测34例良性子宫平滑肌瘤(UL)、40例交界性子宫平滑肌瘤(BLM)和35例子宫平滑肌肉瘤(LMS)中IMP3、Ki-67、P53、Bcl-2的表达。结果(1)IMP3在UL、BLM及LMS中的阳性表达率为0、5%及54.3%,差异有统计学意义(P<0.01);BLM与LMS组间比较(P<0.01),而BLM与UL组比较(P>0.05);(2)Ki-67、P53在UL、BLM、LMS组中的表达率均逐步升高,差异有统计学意义(P<0.05),且LMS组均高于BLM组(P<0.05);(3)Bcl-2在UL、BLM、LMS组中的表达率逐步下降,差异有统计学意义(P<0.01),且BLM组高于LMS组(P<0.05);(4)在109例标本中,对LMS检测的敏感度:Ki-67>P53>IMP3>Bcl-2;而检测的特异度:IMP3>P53>Ki-67>Bcl-2。结论IMP3有助于良恶性子宫平滑肌肿瘤的区别,IMP3、Ki-67、P53及Bcl-2在不同组别子宫平滑肌肿瘤中表达情况各异,联合检测可用于提高子宫平滑肌肉瘤的诊断率。

Objective To investigate the expression and value of IMP3, Ki-67,P53 and Bcl-2 protein in uterine smooth muscle tumors. Methods Immunohistochemistry was used to detect the expression of IMP3, Ki-67, P53 and Bcl-2 in 34 cases of benign uterine leiomyoma (UL), 40 cases of borderline uterine leiomyoma (BLM) and 35 cases of uterine leiomyosarcoma (LMS). Results (1) The positive rates of IMP3 in UL, BLM and LMS were 0, 5% and 54.3%, with significant difference (P < 0.01). BLM was compared with LMS group (P < 0.01), while BLM was compared with UL group (P > 0.05).(2) The expression rates of Ki-67 and P53 in UL, BLM and LMS groups increased gradually, and the difference was statistically significant (P < 0.05), and the expression rates of Ki-67 and P53 in LMS group were higher than those in BLM group (P < 0.05).(3) The expression rate of Bcl-2 in UL, BLM and LMS groups decreased gradually, the difference was significant (P < 0.01), and the expression rate in BLM group was higher than that in LMS group (P < 0.05).(4) In 109 samples, the sensitivity of LMS detection was Ki-67 > P53 > IMP3 > Bcl-2, while the specificity of LMS detection was IMP3 > P53 > Ki-67 > Bcl-2. Conclusion IMP3 is helpful to differentiate between benign and malignant uterine leiomyosarcomas. IMP3, Ki-67, P53 and Bcl-2 are expressed differently in different groups of uterine leiomyosarcomas. Combined detection can be used to improve the diagnostic rate of uterine leiomyosarcomas.