Xiang Da-Jun, Xue Wen-Qun, Feng Yi-Zhong, Lu Yi-Nong, Chen Ping-Qian, Wang Jia-Yuan
Department of Oncology, Wuxi Hospital for Maternal and Child Health Care, Wuxi, Jiangsu, PR China.
Ai Zheng. 2003 Jun;22(6):592-6.
BACKGROUND & OBJECTIVE: The pathogenesis of endometrial carcinoma has not been clear yet. The aim of this study was to investigate the influence of expression of CD44v6, bcl-2, and vascular endothelial growth factor (VEGF) on oncogenesis and progression in endometrial carcinoma.
The expression levels of CD44v6, bcl-2, and VEGF were determined using immunohistochemistry in 55 cases with endometrial adenocarcinoma, 10 cases each of normal proliferative endometrium, simple hyperplasia, and atypical hyperplasia, respectively.
(1)The expression of CD44v6 and VEGF increased gradually from normal proliferative endometrium to simple hyperplasia, atypical hyperplasia,and adenocarcinoma, which showed highly significant difference (P< 0.001, P< 0.001), whose ratios were 10%, 40%, 60%, 78.18% and 0%, 0%, 10%, 83.64%,respectively. While the expression of bcl-2 showed no significant difference among the above different tissues. (2)The CD44v6 expression in endometrial carcinoma was inversely associated with surgical stages and lymph node metastasis(P< 0.05, P< 0.01). The bcl-2 expression was found to be significantly related to histologic grades of the tumor (P< 0.05). The VEGF expression was significantly associated with surgical stages, myometrial invasion, and lymph node status. (3)There was statistically significant correlation between bcl-2 and CD44v6, bcl-2 and VEGF expression (P< 0.05, P< 0.05). (4)The univariate analysis revealed that the expression of CD44v6 and bcl-2 were significantly related to the prognosis of the patients (P< 0.01, P< 0.05). Cox proportional hazards model analysis showed that the prognosis was independently affected by age, surgical stage, and CD44v6 expression.
CD44v6, bcl-2, and VEGF play roles in oncogenesis and progression of endometrial adenocarcinoma. Detection of these gene proteins may be helpful for early diagnosis, prognosis prediction, and treatment of endometrial carcinoma.
子宫内膜癌的发病机制尚不清楚。本研究旨在探讨CD44v6、bcl-2和血管内皮生长因子（VEGF）的表达对子宫内膜癌发生发展的影响。
采用免疫组织化学法检测55例子宫内膜腺癌患者以及分别10例正常增殖期子宫内膜、单纯性增生和不典型增生患者中CD44v6、bcl-2和VEGF的表达水平。
（1）CD44v6和VEGF的表达从正常增殖期子宫内膜到单纯性增生、不典型增生及腺癌呈逐渐升高趋势，差异有高度统计学意义（P<0.001，P<0.001），其阳性率分别为10%、40%、60%、78.18%和0%、0% 、10%、83.64%。而bcl-2在上述不同组织中的表达差异无统计学意义。（2）子宫内膜癌中CD44v6的表达与手术分期及淋巴结转移呈负相关（P<0.05，P<0.01）。发现bcl-2的表达与肿瘤组织学分级显著相关（P<0.05）。VEGF的表达与手术分期、肌层浸润及淋巴结状态显著相关。（3）bcl-2与CD44v6、bcl-2与VEGF表达之间存在统计学显著相关性（P<0.05，P<0.05）。（4）单因素分析显示，CD44v6和bcl-2的表达与患者预后显著相关（P<0.01，P<0.05）。Cox比例风险模型分析表明，预后独立受年龄、手术分期和CD44v6表达的影响。
CD44v6、bcl-2和VEGF在子宫内膜腺癌的发生发展中起作用。检测这些基因蛋白可能有助于子宫内膜癌的早期诊断、预后预测及治疗。
