Kounelis S, Kapranos N, Kouri E, Coppola D, Papadaki H, Jones M W
Department of Pathology, Helena Venizelou Women's Hospital, Athens, Greece.
Mod Pathol. 2000 Apr;13(4):379-88. doi: 10.1038/modpathol.3880062.
The differences in immunohistochemical expression of p53, bcl-2, bax, estrogen receptor (ER), and progesterone receptor (PR) were evaluated in 40 endometrioid and 21 papillary serous carcinomas of endometrium and correlated with known predictors of survival, such as grade and stage. Uterine papillary serous adenocarcinomas (UPSA) showed significantly higher p53 expression than did uterine endometrioid adenocarcinomas (UEA) (76.2% versus 35%), whereas both ER and PR were more often positive in endometrioid than in serous tumors (p = .005 and .0005). No significant difference was found in bcl-2 and bax expression between both histologic types. However, there was definite decrease in intensity of bcl-2 in UPSA compared with UEA. In endometrioid carcinoma, p53 overexpression was associated with high-grade and advanced-stage tumors (p = .0006 and .006), whereas ER and PR expression was associated with low-grade and early-stage tumors (p = .0006 and .0001; p = .003 and .0006). Bcl-2 immunopositivity was more common in low-grade, early-stage rather than in high-grade, advanced-stage adenocarcinomas, but the difference was not statistically significant (p = .24 and .07). Bax immunopositivity was associated with well-differentiated (p = .04) and early-stage tumors. Furthermore, a significant inverse relationship between bax and p53 reactivity was defined (p = .05), especially in tumors of endometrioid type. Bax and PR immunoexpression correlated near the limit of statistical significance (p = .08), whereas no relationship was found among bax, bcl-2, and ER immunopositivity. Our results indicate that the differences in immunohistochemical profiles of endometrioid and serous carcinomas support the existence of different molecular pathways of their development. The correlation of immunohistochemical findings with histologic grade and clinical stage could help in predicting biologic behavior and planning treatment in patients who are diagnosed as having these tumors.
在40例子宫内膜样癌和21例子宫内膜乳头状浆液性癌中评估了p53、bcl-2、bax、雌激素受体（ER）和孕激素受体（PR）的免疫组化表达差异，并将其与已知的生存预测指标（如分级和分期）相关联。子宫乳头状浆液性腺癌（UPSA）的p53表达显著高于子宫子宫内膜样腺癌（UEA）（76.2%对35%），而ER和PR在子宫内膜样癌中阳性的频率高于浆液性肿瘤（p = 0.005和0.0005）。两种组织学类型之间的bcl-2和bax表达未发现显著差异。然而，与UEA相比，UPSA中bcl-2的强度确实降低。在子宫内膜样癌中，p53过表达与高级别和晚期肿瘤相关（p = 0.0006和0.006），而ER和PR表达与低级别和早期肿瘤相关（p = 0.0006和0.0001；p = 0.003和0.0006）。Bcl-2免疫阳性在低级别、早期腺癌中比在高级别、晚期腺癌中更常见，但差异无统计学意义（p = 0.24和0.07）。Bax免疫阳性与高分化（p = 0.04）和早期肿瘤相关。此外，定义了bax与p53反应性之间存在显著的负相关（p = 0.05），特别是在子宫内膜样型肿瘤中。Bax和PR免疫表达在接近统计学意义的极限处相关（p = 0.08），而在bax、bcl-2和ER免疫阳性之间未发现相关性。我们的结果表明，子宫内膜样癌和浆液性癌免疫组化谱的差异支持它们存在不同的分子发育途径。免疫组化结果与组织学分级和临床分期的相关性有助于预测诊断为这些肿瘤的患者的生物学行为并规划治疗。
