McCluggage W G, Maxwell P, Hamilton P W, Jasani B
Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland.
Histopathology. 1999 Jan;34(1):51-5. doi: 10.1046/j.1365-2559.1999.00579.x.
Metallothioneins (MTs) are a group of ubiquitous low molecular weight proteins with a high affinity for heavy metal ions. The aim of the present study was to investigate MT expression in a series of endometrial carcinomas. We wished to determine whether MT expression in endometrial carcinoma was related to established prognostic factors such as tumour grade, stage and histological type. We also wanted to establish if high MT expression in curettings of endometrial carcinoma was predictive of high expression in the subsequent hysterectomy specimen.
Sixty-three cases of endometrial carcinoma were included in the study. These comprised 57 endometrioid adenocarcinomas (15 grade 1, 25 grade 2, 17 grade 3), three papillary serous adenocarcinomas, two mucinous adenocarcinomas and one clear cell adenocarcinoma. Forty-five tumours were stage I, 10 were stage II and eight were stage III. In 28 cases, diagnostic endometrial curettings, performed prior to hysterectomy, were available for study. Immunohistochemical staining was performed using the anti-MT monoclonal antibody E9. The intensity and distribution of MT staining were assessed using a semiquantitative method. This resulted in an intensity distribution (ID) score out of a maximum of 300. The mean ID score of grade 1 and 2 endometrioid adenocarcinomas was 67 and 63, respectively, while for grade 3 tumours the mean ID score was 114. This was statistically significant (P = 0.05). The three papillary serous adenocarcinomas had high ID scores with a mean of 208. The mean ID score of stage I tumours was 69. This was lower than those of stage II and III tumours which had mean ID scores of 116 and 128, respectively. However, these differences were not statistically significant (P = 0.288). A significant correlation was observed between MT ID scores in endometrial curettings and in the subsequent hysterectomy (P = 0.013).
MT isoforms can be demonstrated in most endometrial adenocarcinomas. High MT ID scores are associated with high grade and high stage endometrial adenocarcinomas and with the aggressive papillary serous adenocarcinoma. Whether this is of value as an independent prognostic factor has yet to be established.
金属硫蛋白（MTs）是一类普遍存在的低分子量蛋白质，对重金属离子具有高亲和力。本研究的目的是调查一系列子宫内膜癌中MT的表达情况。我们希望确定子宫内膜癌中MT的表达是否与已确定的预后因素如肿瘤分级、分期和组织学类型有关。我们还想确定子宫内膜癌刮宫标本中MT的高表达是否能预测后续子宫切除标本中的高表达。
本研究纳入了63例子宫内膜癌病例。其中包括57例子宫内膜样腺癌（15例1级、25例2级、17例3级）、3例乳头状浆液性腺癌、2例黏液性腺癌和1例透明细胞腺癌。45例肿瘤为I期，10例为II期，8例为III期。28例病例在子宫切除术前进行了诊断性子宫内膜刮宫，可供研究。使用抗MT单克隆抗体E9进行免疫组织化学染色。采用半定量方法评估MT染色的强度和分布。这得出了一个强度分布（ID）分数，最高为300分。1级和2级子宫内膜样腺癌的平均ID分数分别为67分和63分，而3级肿瘤的平均ID分数为114分。这具有统计学意义（P = 0.05）。3例乳头状浆液性腺癌的ID分数较高，平均为208分。I期肿瘤的平均ID分数为69分。这低于II期和III期肿瘤，II期和III期肿瘤的平均ID分数分别为116分和128分。然而，这些差异无统计学意义（P = 0.288）。观察到子宫内膜刮宫标本和后续子宫切除标本中的MT ID分数之间存在显著相关性（P = 0.013）。
大多数子宫内膜腺癌中可检测到MT异构体。MT高ID分数与高级别和高分期子宫内膜腺癌以及侵袭性乳头状浆液性腺癌相关。这是否作为独立的预后因素具有价值尚未确定。
