1st Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Maistrasse 11, 80337 Munich, Germany.
Arch Gynecol Obstet. 2011 Aug;284(2):467-76. doi: 10.1007/s00404-010-1680-1. Epub 2010 Sep 24.
Inhibins and activins are secreted polypeptides of the transforming growth factor-β superfamily that comprise a subfamily of dimeric, disulphide-linked proteins. Inhibins are composed of an alpha subunit and one of two possible beta subunits (βA or βB), while activins are homodimers of the beta subunits. Both inhibins and activins play substantial roles in human reproduction and endocrine-responsive tumors. However, the prognostic significance and clinical implications of inhibin-βA subunits in uterine endometrioid adenocarcinomas have not been defined.
A series of 229 uterine endometrioid adenocarcinomas from a previously well-characterized cohort were re-evaluated for expression of the inhibin-βA subunit and correlated with several clinicopathological characteristics and clinical outcomes. Both staining intensity and analyses of a semi-quantitative score were used to evaluate inhibin-βA immunolabeling.
The inhibin-βA subunit was present in malignant endometrioid uterine tissue, and was associated with myometrial invasion (p < 0.05). Univariate survival analysis demonstrated no differences in progression-free survival, cause-specific survival and overall survival for inhibin-βA using the median of the calculated semi-quantitative score. However, patients with a positive inhibin-βA, as identified by staining intensity, demonstrated significantly worse cause-specific survival (p < 0.05).
Evaluation of staining intensity revealed better cause-specific survival in patients with negative or low inhibin-βA immunolabeling intensity. Therefore, although of some use, semi-quantification of immunohistochemical reactions might not be definitive for evaluation of the inhibin-βA subunit as a prognostic marker in endometrial cancer patients. Therefore, staining intensity evaluation should be performed in addition to semi-quantitative analysis. Further research is warranted to elucidate the possible implications of inhibin-βA and endometrial carcinogenesis.
抑制素和激活素是转化生长因子-β 超家族的分泌多肽，它们构成二聚体、二硫键连接蛋白的亚家族。抑制素由一个α亚基和两个β亚基（βA 或βB）中的一个组成，而激活素是β亚基的同源二聚体。抑制素和激活素在人类生殖和内分泌反应性肿瘤中都发挥重要作用。然而，抑制素-βA 亚基在子宫内膜样腺癌中的预后意义和临床意义尚未确定。
对一组 229 例来自先前特征明确队列的子宫内膜样腺癌进行重新评估，评估抑制素-βA 亚基的表达，并与几种临床病理特征和临床结局相关。采用染色强度和半定量评分分析两种方法来评估抑制素-βA 免疫标记。
抑制素-βA 亚基存在于恶性子宫内膜样子宫组织中，与肌层浸润有关（p<0.05）。单因素生存分析显示，采用计算的半定量评分中位数，抑制素-βA 在无进展生存率、无病生存率和总生存率方面没有差异。然而，通过染色强度确定的抑制素-βA 阳性患者的无病生存率明显较差（p<0.05）。
染色强度评估显示，抑制素-βA 免疫标记强度阴性或低的患者的无病生存率更差。因此，尽管具有一定的用途，但免疫组化反应的半定量分析可能不足以确定抑制素-βA 作为子宫内膜癌患者的预后标志物。因此，除了半定量分析外，还应进行染色强度评估。需要进一步研究来阐明抑制素-βA 和子宫内膜癌发生的可能意义。
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