p16、Ki-67在子宫内膜癌组织中的表达及与患者预后的关系

Expression of p16 and Ki-67 in endometrial cancer tissue and their relationship with prognosis

目的探讨p16、Ki-67在子宫内膜癌组织中的表达及与患者预后的关系。方法取89例子宫内膜癌患者的子宫内膜癌组织和75例子宫肌瘤患者的正常子宫内膜组织,免疫组化法检测p16、Ki-67表达情况。比较不同临床特征子宫内膜癌患者子宫内膜癌组织中p16、Ki-67的表达情况;随访2年,子宫内膜癌患者预后的影响因素采用Logistic回归模型分析。结果子宫内膜癌组织中p16的阳性表达率低于正常子宫内膜组织,Ki-67的阳性表达率高于正常子宫内膜组织,差异均有统计学意义(P﹤0.05)。国际妇产科联盟(FIGO)分期为Ⅲ~Ⅳ期、分化程度为中低分化、有淋巴结转移子宫内膜癌患者子宫内膜癌组织中p16蛋白的阳性表达率分别低于FIGO分期为Ⅰ~Ⅱ期、分化程度为高分化、无淋巴结转移患者,差异均有统计学意义(P﹤0.05)。FIGO分期为Ⅲ~Ⅳ期、分化程度为中低分化、有淋巴结转移、肌层浸润深度﹥1/2子宫内膜癌患者子宫内膜癌组织中Ki-67蛋白的阳性表达率分别高于FIGO分期为Ⅰ~Ⅱ期、分化程度为高分化、无淋巴结转移、肌层浸润深度≤1/2患者,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,FIGO分期为Ⅲ~Ⅳ期、分化程度为中低分化、有淋巴结转移、p16阴性表达、Ki-67阳性表达均为子宫内膜癌患者预后的独立危险因素(P﹤0.05)。结论p16、Ki-67在子宫内膜癌组织中表达异常,p16阴性表达、Ki-67阳性表达均为子宫内膜癌患者预后的独立危险因素,可作为预测子宫内膜癌患者预后的分子标志物和潜在治疗靶点。

Objective To explore the expression of p16 and Ki-67 in endometrial cancer tissue and their relationship with prognosis.Method The expression of p16 and Ki-67 were detected by immunohistochemical method in 89 endometrial cancer tissues and 75 normal endometrial tissues with uterine fibroids.The expression of p16 and Ki-67 in endometrial cancer tissues of patients with different clinical characteristics were compared.After 2 years follow-up,the prognosis factors of endometrial cancer patients were analyzed by Logistic regression model.Result The positive expression rate of p16 in endometrial cancer tissues was lower than that in normal endometrial tissues,and the positive expression rate of Ki-67 was higher than that in the normal endometrial tissues,the differences were statistically significant(P<0.05).The positive expression rate of p16 protein in endometrial cancer tissue of patients with International Federation of Obstetrics and Gynecology(FIGO)stage Ⅲ-Ⅳ,moderate to low differentiation,and lymph node metastasis were lower than those of patients with FIGO stage Ⅰ-Ⅱ,high differentiation,and no lymph node metastasis,the differences were statistically significant(P<0.05).The positive expression rate of Ki-67 protein in endometrial cancer tissue of patients with FIGO stage Ⅲ-Ⅳ,moderate to low differentiation,lymph node metastasis,and myometrial invasion depth>1/2 were higher than those of FIGO stage Ⅰ-Ⅱ,high differentiation,no lymph node metastasis,and myometrial invasion depth≤1/2,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that FIGO staging of stage Ⅲ-Ⅳ,moderate to low differentiation,lymph node metastasis,p16 negative expression,and Ki-67 positive expression were independent risk factors for the prognosis of endometrial cancer patients(P<0.05).Conclusion p16 and Ki-67 are abnormally expressed in endometrial cancer tissues.Both p16 negative expression and Ki-67 positive expression are independent risk factors for the prognosis of endometrial cancer patients,and can serve as molecular markers and potential therapeutic targets for predicting the prognosis of endometrial cancer patients.