Brustmann H, Naudé S
Department of Pathology, Landeskrankenhaus, Mödling/Vienna, Austria.
Pathol Res Pract. 1999;195(12):829-34. doi: 10.1016/S0344-0338(99)80105-8.
This study evaluated the expression of nm23 in curettage specimens from 63 cases of normal, hyperplastic and neoplastic endometrial tissues by immunohistochemistry. The histological diagnoses were as follows: normal proliferative (N = 5) or secretory (N = 5), simple hyperplasia (N = 11), complex hyperplasia (N = 9), atypical hyperplasia (N = 8) and adenocarcinoma (N = 25), consisting of endometrioid adenocarcinoma (N = 15), clear cell (N = 7) and serous papillary adenocarcinoma (N = 3). There was no immunostaining for nm23 protein in the 10 cases of normal endometria and in the 28 cases of endometrial hyperplasia. In contrast, 52% of the adenocarcinomas displayed a cytoplasmic staining pattern which was moderate to strong. This difference was statistically significant (p < 0.0001, chi-square test). nm23 expression in curettage specimens had no predictive value for determining the FIGO stage in the hysterectomy specimens (p = 0.2709, chi-square test). No significant difference for nm23 immunoreactivity was found between the histologic subtypes of endometrial adenocarcinoma (endometrioid versus serous papillary and clear cell, p = 0.1413, chi-square test). In this study, there was no immunostaining of normal endometria or of endometrial hyperplasia (including atypical endometrial hyperplasia) to support the hypothesis that expression of the nm23 gene product is related to the development of endometrial adenocarcinoma. In contrast, nm23 expression was upregulated in many cases of endometrial adenocarcinomas irrespective of the histologic subtype.
本研究采用免疫组织化学方法评估了63例正常、增生和肿瘤性子宫内膜组织刮宫标本中nm23的表达情况。组织学诊断如下:正常增殖期(N = 5)或分泌期(N = 5)、单纯性增生(N = 11)、复杂性增生(N = 9)、不典型增生(N = 8)和腺癌(N = 25),其中子宫内膜样腺癌(N = 15)、透明细胞癌(N = 7)和浆液性乳头状腺癌(N = 3)。10例正常子宫内膜和28例子宫内膜增生病例中未检测到nm23蛋白免疫染色。相比之下,52%的腺癌呈现中度至强阳性的细胞质染色模式。这种差异具有统计学意义(p < 0.0001,卡方检验)。刮宫标本中nm23的表达对确定子宫切除标本中的国际妇产科联盟(FIGO)分期没有预测价值(p = 0.2709,卡方检验)。子宫内膜腺癌的组织学亚型(子宫内膜样癌与浆液性乳头状癌和透明细胞癌)之间nm23免疫反应性无显著差异(p = 0.1413,卡方检验)。在本研究中,正常子宫内膜或子宫内膜增生(包括不典型子宫内膜增生)均未出现免疫染色,无法支持nm23基因产物的表达与子宫内膜腺癌发生相关的假说。相反,许多子宫内膜腺癌病例中nm23表达上调,与组织学亚型无关。