子宫内膜癌中端粒酶与c-myc基因、P53蛋白和激素受体表达及相关性

Human telomerase,P53, estrogen and progesterore receptor expression in endometrial carcinoma

目的 :探讨端粒酶逆转录酶 (humantelomerasereversetranscriptase,hTERT)基因及c myc基因、P5 3蛋白、雌激素 (estrogenreceptor,ER)和孕激素受体 (progesteronereceptor,PR)在子宫内膜增生癌变中的作用及相关性。 方法 :收集内膜单纯、复合、非典型增生和内膜癌各 1 4、8、1 0和 5 2例。用原位杂交和免疫组织化学法分别检测hTERT、c mycmRNA和P5 3蛋白、ER、PR表达。结果 :(1 )hTERT在内膜单纯、复合、非典型增生和内膜癌中阳性率分别为 1 4 .3%(2 / 1 4 )、5 0 .0 % (4 / 8)、80 .0 % (8/ 1 0 )和 92 .3% (4 8/ 5 2 ) ,后两组hTERT表达显著高于前两组 (P <0 .0 5 )。后两组c myc和P5 3表达亦高于前两组。ER、PR在各组表达差异无显著性。 (2 )hTERT、c myc、P5 3及PR表达与肿瘤分化相关。有淋巴结转移组c myc表达高于无转移组。Ⅱ型内膜癌c myc、P5 3阳性率高于Ⅰ型。(3) 5 2例内膜癌中hTERT与c myc表达呈正相关 (r=0 .3988,P <0 .0 5 ) ;1 0例Ⅱ型内膜癌中hTERT与P5 3蛋白表达呈正相关 (r =1 .0 0 0 ,P <0 .0 5 )。hTERT与ER、PR不相关 (P >0 .0 5 )。结论 :hTERT、c mycmRNA及P5 3蛋白表达与子宫内膜非典型增生及恶性转化相关。hTERT ,c myc基因 ,P5 3蛋白和PR与肿瘤预后不良因素有关。c myc基因。

Objective: To study the role of hTERT and c myc, P53, ER, PR in endometrial carcinoma carcinogenesis. Methods: The expression of hTERT, c myc mRNA, P53 protein, ER and PR examined by in situ hybridization and immunohistochemistry in 14 cases of endometrial simple hyperplasia, 10 of complex hyperplasia, 8 of atypical hyperplasia and 52 with endometrial carcinoma. Results: (1) The positve rate of hTERT in simple, complex, atypical hyperlasia and carcinoma were 14.3% (2/14), 50.0% (4/8), 80.0% (8/10) and 92.3% (48/52), respectively. The prevalence and intensity of hTERT signal were greater in the carcinomas and atypical hyperplasia than those in simple or complex hyperplasia (P <0.05). The expressions of c myc and P53 were similar to that of hTERT. (2) The expressions of hTERT, c myc, P53 and PR were significantly correlated with tumor differentiation. The expressions of c myc and P53 in type I were significantly different from those in type II. The expression of c myc with lymph node metastasis was significantly higher than that without metastasis. (3) The positive correlation between hTERT and c myc was found in endometrial carcinoma ( r= 0.398 8 , P <0.05); It was also found between hTERT and P53 in type II endometrial carcinoma ( r= 1.000, P <0.05). Conclusion: The expressions of hTERT, c myc and P53 may be involved in the progression from the endometrial aypictal hyperplasia to cancer. They may also be associated with the prognosis of endometial carcinoma. c myc and P53 may play a role in the transcriptive activation of hTERT gene in endometrial carcinoma.