子宫内膜异位症相关卵巢癌患者上皮-间充质转化相关蛋白的表达及其影响因素

Expressions of related proteins of epithelial-mesenchymal transition and their influencing factors in patients with endometriosis-associated ovarian cancer

目的探讨子宫内膜异位症相关卵巢癌(EAOC)患者上皮-间充质转化(EMT)相关蛋白的表达及其影响因素分析。方法取60例EAOC患者及60例单纯子宫内膜异位症(EMS)患者的EAOC组织和EMS组织采用免疫组织化学法检测,比较各组织中EMT相关蛋白[上皮钙黏蛋白(E-cadherin)、神经钙黏蛋白(N-cadherin)及锌指转录因子Snail]的阳性表达情况,分析EAOC组织中EMT相关蛋白阳性表达的影响因素及其相关性。结果EAOC组织中E-cadherin蛋白阳性表达率低于EMS组织(P﹤0.05),N-cadherin及Snail蛋白阳性表达率均高于EMS组织(P﹤0.05)。临床分期为Ⅰ~Ⅱ期、无淋巴结转移的EAOC患者EAOC组织中E-cadherin蛋白阳性表达率均高于临床分期为Ⅲ~Ⅳ期、有淋巴结转移的患者(P﹤0.05);临床分期为Ⅰ~Ⅱ期、无淋巴结转移的EAOC患者EAOC组织中N-cadherin蛋白阳性表达率均低于Ⅲ~Ⅳ期、有淋巴结转移的患者(P﹤0.05);无淋巴结转移的EAOC患者EAOC组织中Snail蛋白阳性表达率低于有淋巴转移患者(P﹤0.05)。多因素Logistic回归分析结果显示,临床分期为Ⅲ~Ⅳ期、有淋巴结转移均是E-cadherin蛋白阳性表达的独立危险因素(P﹤0.05),无淋巴结转移是N-cadherin、Snail蛋白阳性表达的独立危险因素(P﹤0.05)。Spearman相关性分析显示,EAOC患者EAOC组织中E-cadherin蛋白阳性表达与其临床分期及淋巴转移情况呈负相关(r=-0.36、-0.44,P﹤0.05),而N-cadherin蛋白阳性表达与其临床分期及淋巴转移情况呈正相关(r=0.42、0.37,P﹤0.05),Snail蛋白阳性表达与其淋巴转移情况呈正相关(r=0.34,P﹤0.05)。结论EAOC患者临床分期及淋巴转移与其病灶组织中E-cadherin、N-cadherin及Snail蛋白阳性表达存在相关性,提示EAOC的进展可能与EMT相关蛋白间有密切联系。

Objective To explore the expressions of related proteins of epithelial-mesenchymal transition(EMT)and their influencing factors in patients with endometriosis-associated ovarian cancer(EAOC).Method The tissues of 60 patients with EAOC and 60 patients with endometriosis(EMS)were detected by immunohistochemistry.The positive expression levels of EMT related proteins E-cadherin,N-cadherin and zinc finger transcription factor Snail were compared among their tissues.The influencing factors of protein expressions of EMT related proteins in EAOC tissues and their correlation were analyzed.Result The positive expression rate of E-cadherin protein in EAOC tissue was lower than that in EMS tissue(P<0.05),and the positive expression rate of N-cadherin and Snail protein was higher than that in EMS tissue(P<0.05).The positive expression rate of E-cadherin protein in EAOC patients with clinical stage Ⅰ-Ⅱ and without lymph node metastasis were higher than that in patients with clinical stage Ⅲ-Ⅳ and lymph node metastasis(P<0.05).The positive expression rate of N-cadherin protein in EAOC patients with clinical stage Ⅰ-Ⅱ and without lymph node metastasis were lower than that in patients with Ⅲ-Ⅳ stage and lymph node metastasis(P<0.05).The positive expression rate of Snail protein in EAOC tissues in EAOC patients without lymph node metastasis was lower than that in patients with lymph node metastasis(P<0.05).Multivariate Logistic regression analysis showed that clinical staging of stage Ⅲ-Ⅳ and lymph node metastasis were independent risk factors for the positive expression of E-cadherin protein(P<0.05),and without lymph node metastasis is an independent risk factor for the positive expression of N-cadherin and Snail protein(P<0.05).Spearman correlation analysis showed that the positive expression of E-cadherin protein in EAOC tissues was negatively correlated with clinical stages and lymphatic metastasis of patients with EAOC(r=-0.36,-0.44,P<0.05),while the positive expression of N-cadherin protein was positively correlated with clinical stages and lymphatic metastasis(r=0.42,0.37,P<0.05),the positive expression of Snail protein was positively correlated with lymphatic metastasis(r=0.34,P<0.05).Conclusion The clinical stages and lymphatic metastasis of patients with EAOC have correlation with positive expressions of E-cadherin,N-cadherin and Snail proteins in lesion tissues,suggesting that the progression of EAOC may be closely related to EMT-related proteins.