乳腺癌术后服用他莫昔芬患者子宫内膜中PTEN的表达

Expression of PTEN in endometrial disease of patients taking Tamoxifen after breast cancer operation

目的 评估乳腺癌术后服用他莫昔芬(TAM)患者子宫内膜组织中PTEN蛋白的表达情况,从分子生物学水平探讨其与TAM介导子宫内膜病变的关系。方法 选取2018年1~12月首都医科大学附属北京妇产医院随诊的乳腺癌术后服用TAM(20 mg/d)的患者56例,其中因阴道不规则出血或定期随访B超提示子宫内膜异常增厚,住院行宫腔镜诊刮术获得子宫内膜标本的患者10例,拟定为乳腺癌术后服用TAM组;因“宫颈上皮内瘤变Ⅲ级或子宫肌瘤”行全子宫切除术的正常子宫内膜患者10例,拟定为正常子宫内膜组;初治的Ⅰ型子宫内膜腺癌患者10例,拟定为子宫内膜癌组。其中正常子宫内膜组及子宫内膜癌组为对照组。采用免疫组化法测定3组患者子宫内膜组织中PTEN蛋白的表达情况。结果 三组PTEN蛋白定量表达情况比较,差异有统计学意义(P <0.05);子宫内膜癌组PTEN定量表达低于正常子宫内膜组比较,差异有统计学意义(P <0.05)。子宫内膜癌组表达强度低于正常子宫内膜组,乳腺癌术后服用TAM组表达强度低于正常子宫内膜组。结论 PTEN基因可能作为预测TAM相关子宫内膜病变的早期分子标志物,其突变可能在TAM相关子宫内膜病变发展中起重要作用。

Objective To evaluate the expression of PTEN protein in endometrial disease of patients taking Tamoxifen(TAM)after breast cancer operation,and to explore its relationship with TAM-related endometrial disease on a molecular level.Methods From January to December 2018,56 cases with breast cancer receiving TAM(20 mg/d)after surgery in Beijing Obstetrics and Gynecology Hospital,Capital Medical University were selected.Among them,10 cases with irregular vaginal bleeding or regular B-ultrasound follow-up showed abnormal thickening of the endometrium which were hospitalized for hysteroscopic curettage to obtain endometrium specimens were named as TAM group after breast cancer operation.At the same time,10 cases with whole hysterectomy normal endometrium of“the cervical intraepithelial neoplasia gradeⅢor uterine fibroids”were named as normal endometrium group.10 cases withⅠtype of endometrial adenocarcinoma were named as endometrial cancer group.Normal endometrial group and endometrial cancer group were control group.Immunohistochemistry was used to determine the expression of PTEN protein in endometrial tissues of patients in 3 groups.Results The quantitative expression of PTEN protein in the three groups were significantly different(P<0.05).The quantitative expression of PTEN protein in endometrial cancer group was lower than that in normal endometrial group,and the difference was statistically significant(P<0.05).The expression intensity of endometrial cancer group was lower than that of normal endometrial group,and the expression intensity of TAM group after breast cancer operation was lower than that of normal endometrial group.Conclusion The PTEN gene may used as an early molecular marker for predicting TAM-associated endometrial disease,and its mutation may play an important role in the development of TAM-associated endometrial disease.