Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
World J Surg Oncol. 2010 Jul 19;8:60. doi: 10.1186/1477-7819-8-60.
The aim of our study was to evaluate survival outcomes in malignant mixed Mullerian tumors (MMMT) of the uterus with respect to the role of cell cycle and apoptotic regulatory proteins in the carcinomatous and sarcomatous components.
23 cases of uterine MMMT identified from the Saskatchewan Cancer Agency (1970-1999) were evaluated. Immunohistochemical expression of Bad, Mcl-1, bcl-x, bak, mdm2, bax, p16, p21, p53, p27, EMA, Bcl-2, Ki67 and PCNA was correlated with clinico-pathological data including survival outcomes.
Histopathological examination confirmed malignant epithelial component with homologous (12 cases) and heterologous (11 cases) sarcomatous elements. P53 was strongly expressed (70-95%) in 15 cases and negative in 5 cases. The average survival in the p53+ve cases was 3.56 years as opposed to 8.94 years in p53-ve cases. Overexpression of p16 and Mcl-1 were observed in patients with longer survival outcomes (>2 years). P16 and p21 were overexpressed in the carcinomatous and sarcomatous elements respectively. Cyclin-D1 was focally expressed only in the carcinomatous elements.
Our study supports that a) cell cycle and apoptotic regulatory protein dysregulation is an important pathway for tumorigenesis and b) p53 is an important immunoprognostic marker in MMMT of the uterus.
本研究旨在评估细胞周期和凋亡调控蛋白在癌性和肉瘤性成分中的表达与子宫恶性混合性 Mullerian 肿瘤（MMMT）患者生存结局的关系。
从萨斯喀彻温癌症协会（1970-1999 年）中评估了 23 例子宫 MMMT 病例。免疫组织化学分析 Bad、Mcl-1、bcl-x、bak、mdm2、bax、p16、p21、p53、p27、EMA、Bcl-2、Ki67 和 PCNA 的表达与临床病理数据（包括生存结局）相关。
组织病理学检查证实了具有同源（12 例）和异源（11 例）肉瘤成分的恶性上皮成分。p53 在 15 例中强表达（70-95%），在 5 例中阴性。p53 阳性病例的平均生存时间为 3.56 年，而 p53 阴性病例为 8.94 年。p16 和 Mcl-1 的过度表达与生存时间较长（>2 年）的患者相关。p16 和 p21 在癌性和肉瘤性成分中分别过表达。细胞周期蛋白 D1 仅在癌性成分中局灶性表达。
本研究支持：a）细胞周期和凋亡调控蛋白失调是肿瘤发生的重要途径；b）p53 是子宫 MMMT 的重要免疫预后标志物。
