Giordano Mario Vicente, Lucas Hiram Da Silveira, Fiorelli Rossano Kepler Alvim, Giordano Luiz Augusto, Giordano Mario Gáspare, Baracat Edmund Chada, Júnior José Maria Soares
Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil.
Department of Gynecology and Obstetrics, University of São Paulo (USP), São Paulo 05403-000, Brazil.
Mol Clin Oncol. 2020 Dec;13(6):69. doi: 10.3892/mco.2020.2139. Epub 2020 Sep 17.
Obesity is associated with numerous diseases, including endometrial disorders in postmenopausal women, such as adenocarcinoma, hyperplasias and endometrial polyps, and the risk of malignant transformation of these structures. The present study evaluated the influence of body mass index (BMI) on cell proliferation (BCL2 and MKI67) in endometrial polyps in postmenopausal women. A prospective cross-sectional study using immunohistochemical analysis of the expression of a cell proliferation marker (MKI67) and an anti-apoptotic gene (BCL2) in endometrial polyps in postmenopausal women was performed. The patients were divided into three groups depending on BMI: i) <24.9 kg/m (normal); ii) >25 and <29.9 kg/m (overweight); and iii) >30 kg/m (obese). The present study analyzed the expression of these markers in relation to polyp size, histological type and time since menopause in 38 patients. The interpretation of MKI67 and BCL2 expression accounted for the percentage of positive cells (scores): 1 (weak), <5% of cells showed expression; 2 (moderate), between 5 and 50%; and 3 (intense), >50%. Statistical analysis was performed using GraphPad InStat version 3.00 software. ANOVA was used to analyze BCL2 and MKI67 expression. A significance level of P<0.05 was adopted for rejecting the null hypothesis. There was greater glandular expression of MKI67 in obese women than in normal weight women (P=0.02) and greater expression of BCL2 in the stroma of polyps >2 cm (P=0.03). Hyperplastic polyps exhibited hyperexpression of MKI67 (P=0.04) compared with atrophic polyps. No difference in MKI67 and BCL2 expression was identified in the glands and stroma of polyps when comparing overweight and obese postmenopausal patients. The present findings suggest that BMI has an influence on proliferation markers (MKI67) in the polyps of postmenopausal women and that polyps >2 cm exhibit hyperexpression of BCL2 in the stroma.
肥胖与多种疾病相关，包括绝经后女性的子宫内膜疾病，如腺癌、增生和子宫内膜息肉，以及这些病变的恶性转化风险。本研究评估了体重指数（BMI）对绝经后女性子宫内膜息肉细胞增殖（BCL2和MKI67）的影响。采用免疫组织化学分析绝经后女性子宫内膜息肉中细胞增殖标志物（MKI67）和抗凋亡基因（BCL2）表达的前瞻性横断面研究。根据BMI将患者分为三组：i）<24.9kg/m（正常）；ii）>25且<29.9kg/m（超重）；iii）>30kg/m（肥胖）。本研究分析了38例患者中这些标志物的表达与息肉大小、组织学类型和绝经时间的关系。MKI67和BCL2表达的解读依据阳性细胞百分比（评分）：1（弱），<5%的细胞显示表达；2（中度），5%至50%；3（强），>50%。使用GraphPad InStat 3.00软件进行统计分析。采用方差分析来分析BCL2和MKI67的表达。采用P<0.05的显著性水平来拒绝原假设。肥胖女性息肉腺体中MKI67的表达高于正常体重女性（P=0.0），息肉>2cm的间质中BCL2的表达更高（P=0.03）。与萎缩性息肉相比，增生性息肉表现出MKI67的高表达（P=0.04）。比较超重和肥胖的绝经后患者时，息肉腺体和间质中MKI67和BCL2表达无差异。本研究结果表明，BMI对绝经后女性息肉中的增殖标志物（MKI67）有影响，且息肉>2cm时间质中BCL2表现出高表达。
