核仁组成区嗜银蛋白AgNOR在子宫内膜病变组织中的定量研究

目的探讨核仁组成区嗜银蛋白(AgNOR)在子宫内膜腺癌早期诊断与预后中的作用。方法采用银染法染色,检测子宫内膜增殖症25例,非典型增生内膜19例,子宫内膜腺癌63例,共107例为观察组;因患宫颈原位癌子宫切除后的正常子宫内膜组织25例为对照组;计数正常子宫内膜及不同内膜病变组织中单位细胞核内AgNOR的定量值,并对其进行形态学观察。结果AgNOR每核颗粒数在正常子宫内膜(2.51±1.97)、子宫内膜增殖症(2.92±2.02)、非典型增生内膜(3.04±2.05)间相比无统计学意义(P>0.05);在子宫内膜腺癌(7.43±2.18)中,AgNOR颗粒数明显升高,与良性病变组(子宫内膜增殖症、非典型增生内膜)及对照组相比有统计学意义(P<0.05);AgNOR颗粒计数与子宫内膜腺癌的分化程度[高分化(4.69±2.32)、中分化(5.38±2.99)、低分化(7.54±2.09)]、临床分期[Ⅰ期(3.68±3.16)、Ⅱ期(4.53±2.94)、Ⅲ期(7.27±2.84)、Ⅳ期(7.84±2.33)]、淋巴结转移[无转移(3.62±3.27)、有转移(7.68±2.42)]密切相关(P<0.05);AgNOR颗粒的形态分布随着子宫内膜病变的进展由单一型转变为弥散型。结论AgNOR的每核颗粒数及其形态分布与子宫内膜腺癌的发生、发展密切相关;检测AgNOR的定量值对早期诊断子宫内膜腺癌、判断疾病预后有一定的临床价值。

Quantitative study on AgNOR in endometrial diseases

[Objective] To investigate the usage of AgNOR in early diagnosis and prognosis of endometrial adenocarcinoma. [Methods] Experimental group: 107 cases including 25 of endometrial hyperplasia, 19 of atypical proliferation and 63 of endometrial adenocarcinoma. Control group: 25 cases of normal endometrium. Quantitative study and morphometric analysis of AgNORs were taken in different endometrial tissues with silver-staining technique. [Results] AgNORs count had no statistical differences (P＞0.05) in normal endometrium(2.51 ±1.97), endometrial hyperplasia (2.92±2.02) and atypical proliferation (3.04±2.05). In endometrial adenocarcinoma, AgNORs count increased obviously(7.43±2.18), which was higher than benign diseases [endometrial hyperplasia (2.92±2.02), atypical proliferation (3.04±2.05)] and control group (2.51 ±1.97) prominently (P ＜0.05). AgNORs count increased with grade of cellular differentiation (4.69±2.32), (5.38±2.99), (7.54±2.09), clinical phase(3.68±3.16), (4.53±2.94), (7.27±2.84), (7.84±2.33) and lymphatic metastasis (7-68±2.42), (3.62±3.27) (P ＜0.05). AgNORs morphometrics changed from simple type to dispersed type with the progression of endometrial diseases. [Conclusions] The quantitative study and morphometric analysis of AgNORs were correlated to the incidence of endometrial adenocarcinoma, and it could provide evidence for diagnosis of endometrial adenocarcinoma and could be used as a prognostic index in malignancies.