凋亡抑制蛋白Survivin在增生性子宫内膜及子宫内膜癌中的表达

URVIVIN EXPRESSION IN ENDOMETRIAL HYPERPLASIA AND CARCINOMA

目的 研究凋亡抑制蛋白Survivin在正常子宫内膜、增生性子宫内膜及子宫内膜癌中的表达 ,探讨Survivin蛋白在子宫内膜癌发生发展中的作用及其作为预后判断因子的可行性。方法 应用免疫组织化学S P法 ,检测 15例正常子宫内膜、 2 6例增生性子宫内膜及 33例子宫内膜腺癌中Survivin蛋白的表达 ,并结合临床病理特点进行分析。结果 Sur vivin蛋白的阳性表达率在正常子宫内膜 ,增生性子宫内膜及子宫内膜癌中呈上升趋势。正常子宫内膜仅在增生期有微弱的表达 ,而分泌期及绝经期子宫内膜表达全为阴性 ;而Survivin在子宫内膜癌中及不典型增生中的阳性表达率分别为87 88%和 70 0 % ,均明显高于正常内膜 (P <0 0 5 ) ,且两者的过表达率均高于单纯和复合型增生及正常内膜 (P <0 0 5 ) ,但子宫内膜癌中与不典型增生中的Survivin表达率及过表达率均无明显差异。子宫内膜癌中Survivin的表达强度与组织学分级及手术病理分期明显相关 (P <0 0 5 ) ,但与肌层浸润无关。结论 Survivin作为凋亡相关因子和细胞周期调节因子 ,可能参与了与子宫内膜癌的发生发展 ,其过度表达与预后不良相关 ,其检测可为子宫内膜癌的早期诊断、辅助治疗及预后判断提供理论依据。

? Objective To investigate the role of Survivin in the pathogenesis and development of endometrial carcinoma and evaluate their value as a tumor marker and clinical prognostic indicator. Method Immunohistochemical S-P method was performed to detect the expression of survivin in 15 cases of normal endometrium, 26 cases of endometrial hyperplasia, and 33 cases of endometrial carcinoma. The relationship of its expression with clinicopathological variables was examined.Result The trend of the positive expression rate of survivin in normal, hyperplastic and carcinomatous endometrium was upwards. In normal endometrium, only the proliferative phase was weakly positive for survivin, but in endometrial carcinoma and atypical hyperplasia, there was abundant survivin immunoreactivity (87.9% and 70%) in the nucleus and/or cytoplasm of the endometrial carcinoma cells, significantly higher than that of normal endometrium (P<0.05 respectively). And the overexpression rate in these two kinds of endometrium was higher than that in simple and complex hyperplasia and normal endometrium (P<0.05 respectively). But there was no significant difference in the expression andoverexpression rate of survivin between carcinoma and atypical hyperplasia. Moreover, survivin expression in endometrial carcinoma was correlated with histological grade and surgical-pathological stage, but not with invasion to the myometrium. Conclusion The overexpression of Survivin was involved in the progression to malignancy of the endometrium. Survivin may be used as a biomarker in the diagnosis, treatment and prognostic evaluation of endometrial carcinoma.