PCNA与bcl-2,P_(16),P_(53)基因在子宫内膜不典型增生及癌变组织中表达的相关性

The Association between PCNA and bcl-2,P_(16) ,P_(53) Gene Expression in Endometrial Atypical Hyperplasia and in Endometrial Carcinoma

目的 探讨增殖细胞核抗原 (PCNA)及细胞凋亡相关基因bcl 2 ,P16,P53 在子宫内膜不典型增生(EAH)与内膜癌变 (EC)组织中表达的相关性。方法 应用免疫组织化学技术分别对 33例子宫内膜癌 ,35例子宫内膜不典型增生 ,30例单纯性子宫内膜增生 (ESH)组织进行PCNA和bcl 2 ,P16,P53 基因蛋白定位、表达程度、对比差异 ,分析它们之间的关系。结果 EC组和EAH组PCNA ,bcl 2均有阳性表达 ,两组间差异无显著性 ,其表达强度由中到强阳性 ,但这两种在EC和EAH组中表达与其在ESH组比较 ,差异有显著性 (P <0 .0 1)。P16基因随细胞分化程度下降 ,ESH组阳性率 93.33% ,EAH和EC组分别为 74 .2 8% ,6 3.6 4% ,ESH组明显高于EAH组 (P <0 .0 5 )与EC组 (P <0 .0 1) ,而后两者差异无显著性 ,其定位ESH组基因表达均在细胞浆 ,而EAH和EC组基因表达见于细胞核或核浆共同表达。P53 基因在ESH组无阳性表达 ,EAH组阳性率 2 2 .86 % ,EC组阳性率 5 4.5 5 % ,两组比较差异有显著性 (P <0 .0 1)。结论 PCNA ,bcl 2 ,P53 表达在子宫内膜增殖性病变、细胞恶性转化的进程中呈递增趋势 ,而P16趋于递减 ,提示细胞的过度增殖和增殖 凋亡相关基因的表达失衡在子宫内膜恶性转化过程中起重要作用 。

Objective To investigate the association between proliferation cell nucleus antigen (PCNA) and bcl 2,P 16 ,P 53 cell apoptosis gene expression in endometrial atypical hyperplasia (EAH) and endometrial carcinoma (EC).Methods The PCNA,bcl 2,P 16 and P 53 gene expression was examined ,analysedand compared in 33 cases with EC,35 cases with EAH and 30 cases with endometrial simple hyperplasia (ESH) by immunohistochemical method.Results There expression of PCNA and bcl 2 in EC and EAH showed positive,from moderate to strong,with no significant difference between the two groups but significantly higher than that in ESH(P<0.01).The P 16 gene expression decreased with the decrease of cell differentiation.The positive rate in ESH,EAH,EC was 93.33%,74.28%,63.64% respectively.The positive rate in ESH was significantly higher than that in EAH (P<0.05) and EC (P<0.01),but no significant difference between the latter two groups.The P 16 gene expression was detected in cellular plasm in ESH,but in cellular nucleus and/or cellular plasm in EAH and EC.The P 53 gene expression rate in ESH,EAH,EC was 0%,22.86%,54.55% respectively.There was a significant difference between the latter two groups (P<0.01).Conclusion The expression of PCNA,bcl 2,P 53 increases graduallyin endometrial hyperplasia disease and cell maligant transformation,but P 16 decreases.This indicates the out of balance between cell over proliferation and proliferation/apoptosis gene plays an important role in endometrial maligant transformation.The abnormal expression could help to diagnose the endometrial proliferation diseases and predict their biological behavior.