Yao Yuan-yang, Xu Wen-zhan, Wang Yue, Shen Dan-hua, Wang Jian-liu, Wei Li-hui
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2011 Oct 18;43(5):743-8.
To explore the relationships between the expressions of estrogen receptor (ER), progestin receptor (PR), phosphatase and tension homology deleted on chromosome ten (PTEN), p53, Ki-67 and the clinicopathologic features and prognosis in endometrial carcinoma.
The data of clinical characteristics, pathological types, histological grades, follow-ups and the expressions of molecular markers detected by immunohistochemistry, and collected from 200 patients with primary endometrial carcinoma, were analyzed.
(1) In the cases of endometrial carcinoma, the expression rates of ER, PR, PTEN, p53 were 86.5%, 85.5%, 82.1%, and 49.2%, respectively. The expression level of Ki-67 in the tumor tissues was 46.9% ± 24.7%. (2) A negative correlation was observed between the gravidity and the expression of PR (r=-0.191, P=0.007). On the other hand, age and parturition time were in positive correlation with the expression of p53 (r=0.184, P=0.041; r=0.255, P=0.004). (3) The expression rates of ER, PR and p53 in the endometrioid carcinoma exhibited significant differences comparing with other types (P<0.01). (4) A negative correlation was found between the expression of ER and the FIGO staging (r=-0.176, P=0.013). The positive rate of ER in the cases with Stage I was higher than that in cases with Stage II and above (P=0.015). (5) A negative correlation was found between the histological grade and the expressions of ER and PR (r=-0.217, P=0.002; r= -0.317, P=0.000), however, a positive correlation was detected between the grade with the expressions of p53 and Ki-67 (r=0.327, P=0.000; r=0.465, P=0.000). Compared with the grade 3 tumors, the other grades exhibited significant different expression levels of ER, PR, p53, and Ki-67 (P<0.01). (6) A negative correlation was observed between the depth of myometrial invasion and the positive rate of ER (r=-0.142, P=0.047). There were statistically significant different expression rates of ER and PR between the cases whether the cancer invaded the deep myometrium or not (P<0.05). (7) Multivariate survival analysis showed that patients with PR (+) had longer overall survival than those with PR (-) (P=0.011).
The immunohistochemical study of endometrium samples obtained from dilatation and curettage of uterine will be beneficial to the understanding of the clinicopathologic features of the endometrial carcinoma before the operation. The value of estimating the prognosis using the expressions of ER, PTEN, p53 and Ki-67 was negative, except for the expression of PR.
探讨雌激素受体(ER)、孕激素受体(PR)、第10号染色体缺失的磷酸酶和张力蛋白同源物(PTEN)、p53、Ki-67的表达与子宫内膜癌临床病理特征及预后的关系。
分析200例原发性子宫内膜癌患者的临床特征、病理类型、组织学分级、随访情况以及免疫组化检测的分子标志物表达数据。
(1)子宫内膜癌病例中,ER、PR、PTEN、p53的表达率分别为86.5%、85.5%、82.1%和49.2%。肿瘤组织中Ki-67的表达水平为46.9%±24.7%。(2)妊娠次数与PR表达呈负相关(r=-0.191,P=0.007)。另一方面,年龄和分娩次数与p53表达呈正相关(r=0.184,P=0.041;r=0.255,P=0.004)。(3)子宫内膜样癌中ER、PR和p53的表达率与其他类型相比有显著差异(P<0.01)。(4)ER表达与国际妇产科联盟(FIGO)分期呈负相关(r=-0.176,P=0.013)。Ⅰ期病例中ER阳性率高于Ⅱ期及以上病例(P=0.015)。(5)组织学分级与ER和PR表达呈负相关(r=-0.217,P=0.002;r=-0.317,P=0.000),然而,分级与p53和Ki-67表达呈正相关(r=0.327,P=0.00;r=0.465,P=0.000)。与3级肿瘤相比,其他分级的ER、PR、p53和Ki-67表达水平有显著差异(P<0.01)。(6)肌层浸润深度与ER阳性率呈负相关(r=-0.142,P=0.047)。癌组织是否浸润深肌层的病例中,ER和PR的表达率有统计学差异(P<0.05)。(7)多因素生存分析显示,PR(+)患者的总生存期长于PR(-)患者(P=0.011)。
对刮宫获取的子宫内膜样本进行免疫组化研究,有助于术前了解子宫内膜癌的临床病理特征。除PR表达外,用ER、PTEN、p53和Ki-67的表达评估预后的价值为阴性。