增殖细胞核抗原和P_(16)基因在子宫内膜不典型增生的表达及意义

The Significance of PCNA and P_(16) Gene Expression in Endometrial Atypical Hyperplasia

目的 通过原位观察增殖细胞核抗原 (PCNA)和P16基因蛋白的表达 ,探讨其在子宫内膜不典型增生及早期癌变中的意义。方法 应用免疫组织化学SP法分别对 33例子宫内膜癌、4 1例子宫内膜重度不典型增生和 2 0例轻度不典型增生进行PCNA和P16基因的原位标记。结果 PCNA阳性表达强度随子宫内膜病变的病理分级而增强 ,其强阳性表达率在子宫内膜不典型增生和子宫内膜癌差异无显著性 (P >0 .0 5 ) ,但两者与轻度不典型增生比较差异均非常显著 (P <0 .0 1) ,P16基因蛋白阳性表达率以子宫内膜轻度不典型增生为最高 ,两组不典型增生间差异无显著性 (P >0 .0 5 ) ,而分别与内膜癌比较差异均显著 (P <0 .0 1,P <0 .0 5 )。阳性表达部位子宫内膜轻度不典型增生均为胞浆 ,部分子宫内膜重度不典型增生和子宫内膜癌为胞核或核浆。结论 细胞的过度增殖和P16基因的表达异常 。

Objective To evaluate the significance of PCNA and P 16 gene expression on early malignant transformation of endometrial tissues by in situ observation.Methods The PCNA and P 16 gene expression were examined in 33 cases with endometrial carcinoma (EC),41 cases with severe endometrial atypical hyperplasia (SEAH) and 20 cases with mild endometrial atypical hyperplasia (MEAH) using immunohistochemical method.Results There was high expression of PCNA in EC and SEAH with no significant difference between the two (P>0.05),but higher than that of MEAH (P<0.01).The P 16 gene expression was lower in EC than that of SEAH and MEAH (P<0.05,P<0.01).There was no significant difference between the SEAH and MEAH (P>0.05).The P 16 gene expression in MEAH was detected in cellular plasm,but the expressions in EC and part of SEAH were detected in cellular nucleus and/or cellular plasm.Conclusion Cell over proliferation and abnormal regulation of P 16 gene experession may play important roles in the diagnosis and prognosis of early malignant transformation of endometrial arypical hyperplasia.