非典型子宫内膜异位症的免疫标记与恶变潜能

The Immunophenotype and Malignant Potential of Atypical Endometriosis

目的:了解子宫内膜异位症(EMs)、非典型子宫内膜异位症(AEMs)与子宫内膜异位相关卵巢癌(EAOC)相互的发生发展关系,探讨AEMs在EMs组病变中的角色与恶变潜能。方法:应用免疫组化方法检测82例EMs、EMs伴反应性增生、AEMs与EAOC的PTEN、p53、ki67、ER与PR的蛋白表达,分析EMs系列病变的抑癌基因、细胞增殖活性以及激素受体三方面的变化及其相互关系。结果:单纯EMs、反应性增生、AEMs与EAOC的免疫组化标记显示:随病变进展PTEN的缺失与p53的表达升高,ER/PR的表达下降,ki67的表达有明显阶段性。PTEN的缺失始自反应性增生,自AEMs开始p53表达轻度升高,ER的表达显著下降出现在EAOC,PR的表达显著下降始自反应性增生。结论:EMs-AEMs-EAOC的发生与发展是一个连续的过程,AEMs在PTEN、p53的蛋白表达、细胞增殖活性和激素受体等方面与形态学表现一致,兼具EMs的特点与肿瘤的部分特征,提示AEMs有更高的恶变潜能。

Objective :To investigate the development correlation between EMs ,AEMs and EAOC and to explore the role and malignant potential of AEMs in the serial lesions of EMs .Methods :Immunohistochemical staining was used to detect the expression of PTEN ,p53 ,ki67 ,ER and PR in 82 cases of EMs ,EMs with reactive hyperplasia ,AEMs and EAOC .Results :Immunohistochemistry results of the spectrum of EMs-AEMs-EAOC indicated :with the development of lesions ,PTEN loss and p53 expression increased ;ER and PR expression decreased ;the intensity of ki67 expression showed different staging ;PTEN loss begun from reactive hyperplasia ;increasing of p53 expression from AEMs ;de-creasing of ER expression from EAOC and PR from reactive hyperplasia .Conclusion:The development of EMs-AEMs-EAOC is a consecutive process ;histological changes and immunophenotype are conformity ;AEMs have hold some fea-tures of EMs and tumor not only in histology but also in immunophenotype .These features suggest AEMs have a rela-tively higher potential for tumorigenesis and canceration .