原发性子宫内膜癌血清PON-1活性及Q192R基因多态性的检测及临床意义

Detection and clinical significance of serum PON-1 activity and Q192R gene polymorphism in primary endometrial carcinoma

目的:探讨血清中对氧磷酶-1(paraoxonase-1,PON-1)的表达活性及PON-1Q192R基因多态性与原发性子宫内膜癌的相关性。方法:选取2019年01月至2020年10月于我医院就诊的30例子宫内膜腺癌、30例子宫内膜非典型增生和30例正常子宫内膜患者为研究对象,检测3组入选者血清PON-1对有机磷脂酶、芳香脂酶、同型半胱氨酸硫内酯酶活性及Q192R表型,分析3组患者血清PON-1的表达活性差异、Q192R基因表达差异和子宫内膜癌组不同病理分级分期PON-1活性差异。探讨血清中PON-1活性、Q192R基因多态性与子宫内膜癌的相关性。结果:三组患者的一般情况无差异。子宫内膜癌组患者血清中PON-1对有机磷脂酶、芳香脂酶及同型半胱氨酸硫内酯酶的活性表达明显低于子宫内膜不典型增生组及正常子宫内膜组患者,其差异有统计学意义(P<0.05)。血清PON-1活性的降低与子宫内膜癌FIGO分期、分化程度、肌层浸润深度及淋巴结转移相关,其差异有统计学意义(P<0.05),血清PON-1活性与子宫内膜癌病理类型及宫颈受累情况无关(P> 0.05)。正常子宫内膜组的Q192R基因分布、基因频率分别与子宫内膜癌组、子宫内膜不典型增生组相比,其差异有统计学意义(P<0.05),所以Q192R基因影响子宫内膜癌的发病风险。结论:较正常子宫内膜、子宫内膜不典型增生的患者,原发性子宫内膜癌患者血清中PON-1表达活性明显降低,且其活性降低的程度与子宫内膜癌的分化程度、病理分期、肌层浸润及宫颈受累情况相关,与子宫内膜癌病理类型、有无淋巴结转移无关;Q192R基因多态性与原发性子宫内膜癌相关。血清PON-1活性及Q192R基因多态性可能是评价子宫内膜癌患者病情发生、进展及预后的重要指标。

Objective:To investigate the expression activity of paraoxonase-1(PON-1)in serum and the correlation between PON-1Q192R gene polymorphism and primary endometrial carcinoma.Methods:30 patients with endometrial adenocarcinoma(endometrial carcinoma group),30 patients with endometrial atypical hyperplasia(endometrial atypical hyperplasia group)and 30 patients with normal endometrium(normal endometrium group)who were admitted into our hospital from January 2019 to October 2020 were selected as research objects.The activity of serum PON-1 to phospholipase,arylesterase,HTase and the polymorphism of PON-1Q192R gene in the three groups were detected,and the differences in PON-1 expression activity,Q192R gene expression and PON-1 expression activity in endometrial carcinoma group with different pathological grades and stages were analyzed.The correlation between PON-1 activity and Q192R gene polymorphism in serum and endometrial carcinoma were investigated.Results:There was no difference in general condition between the three groups.The expression of serum PON-1 to phospholipase,arylesterase and HTase in patients with endometrial carcinoma was significantly lower than that of patients with atypical hyperplasia of endometrium and normal endometrium,and the difference was statistically significant(P<0.05).The decrease of serum PON-1 activity was correlated with FIGO stage,differentiation degree,myometrial invasion and lymph node metastasis of endometrial carcinoma,and the difference was statistically significant(P<0.05).Serum PON-1 activity was not correlated with pathological type and cervical involvement of endometrial carcinoma(P>0.05).There were significant differences in the distribution and gene frequency of Q192R gene between normal endometrium group and endometrial carcinoma group or endometrial atypical hyperplasia group(P<0.05).Therefore,Q192R gene affects the risk of endometrial carcinoma.Conclusion:Compared with patients with normal endometrium and endometrial atypical hyperplasia,the expression activity of serum PON-1 in patients with primary endometrial carcinoma is significantly reduced,and the degree of decreased activity is correlated with the differentiation degree,pathological stage,myometrial invasion and cervical involvement of endometrial carcinoma,but it is not correlated with the pathological type and lymph node metastasis of endometrial carcinoma.Q192R gene polymorphism is related to primary endometrial carcinoma.Serum PON-1 activity and Q192R gene polymorphism may be important indicators for evaluating the occurrence,progression and prognosis of patients with endometrial adenocarcinoma.