肿瘤转移抑制基因KAI1/ CD82 和雌孕激素受体在子宫内膜癌组织中的表达及其临床意义

 目的 探讨转移抑制基因KAI1／CD82和雌孕激素受体（ER、PR）在子宫内膜癌组织中的表达及与淋巴结转移的关系，并分析其临床意义。方法 应用SP法对76例子宫内膜癌组织中KAI1、PR、ER的蛋白表达情况进行观察。结果 子宫内膜癌组织中KAI1和PR的阳性表达与手术病理分期、组织学分级、肌层浸润深度呈负相关（ P _{KA H}=0．0089、0．0103、0．0356，P_PR=0．0026、0．000、0．0053）；伴有盆腔淋巴结转移、宫旁或附件受累及的组织KAI1、PR、ER的阳性表达均明显低于无转移的组织（PKAII=0．0091、0．0073，PR=0．0006、0．0074，P _ER=0．0129、0．0073）；ER的阳性表达与FIGO分期呈负相关（P=0．0226）；不同的病理类型中，只有PR表达差异有统计学意义（P=0．0446）；而三者的表达与患者年龄及宫颈是否受累均无关。KAI1、PR、ER表达阴性和阳性的生存率差异均有统计学意义（ P _{KA H}=0．0043，P_PR=0．0010，P _ER=0．0124）。Logistic回归模型分析结果提示：KAI1、PR、ER三个变量中只有KAI1与淋巴结转移有关（P=0．0400，OR=0．245）。COX比例风险回归模型分析结果显示：KAI1、PR、ER表达均不是子宫内膜癌的独立预后因素。结论 KAI1表达与子宫内膜癌的淋巴结转移具有相关性，其可作为临床预测子宫内膜癌患者发生淋巴结转移和评估预后的综合指标之一。KAI1在子宫内膜癌发展中所起的作用可能与PR有关，KAI1、PR、ER的缺失表达与子宫内膜癌的发展、治疗及预后密切相关。

Expressions of Metastasis Suppressor Gene KAI1, Estrogen Receptor and Progesterone Receptor in Endometrial Carcinoma Tissues and Their Clinical Significance

Objective 　To investigate the relationship between expressions of tumor metastasis suppressor gene KAI1/ CD82 ,estrogen receptor and progesterone receptor ( ER ,PR) in endomet rial carcinoma tissues and lymph node metastasis ,and study the clinical significance of the relationship between them. Methods The expressions of KAI1 ,PR and ER of 76 cases from Jan. 1998 to Oct . 2005 in Gynecological Tumor Department of Tongji Hospital were studied by immunohistochemistry (SP) ,and assessed under microscopy and analyzed statistically. Results 　The expressions of KAI1 and PR in endomet rial carcinoma tissues were inverse correlated with surgical-pathologic stage ,histological grade and depth of myomet rial invasion ( P _{KA H}= 0. 0089 、0. 0103 、0. 0356 , P_PR = 0. 0026 、0. 000 、0. 0053) ; the expressions of KAI1 、PR and ER in tissues involved in lymph node metastasis ,cervix-side or adnex were significantly lower than the non-metastasis tissues ( P _{KA H}= 0. 0091 、0. 0073 , P _PR = 0. 0006 、0. 0074 , P _ER = 0. 0129 、0. 0073) ; the expression of ER was inverse related to FIGO stage of the tissues ( P = 0. 0226) . Among different pathological types of tissues , Only the difference in the expression of PR was of statistical significance ( P =0. 0446) ; and the expressions of KAI1 ,PR and ER were not related to the age of patient s and the status of cervix involvement . Under Kaplan Meyer analysis the difference in survival rate was significant statistically( P _{KA H} = 0. 0043 , P _PR= 0. 0010 , P _ER= 0. 0124) . Logistic regression analysis showed the expression of KAI1 was related to lymph node metastasis ( P = 0. 0400 ,OR = 0. 245) . The COX proportional hazards regression analysis showed that KAI1 ,PR and ER were all not the independent prognosis factor to endometrial carcinoma. Conclusion 　The expression of KAI1 is correlated with the lymph node metastasis , so KAI1 can be used as a predicting indicator of lymph node metastasis and comprehensive assessment in endomet rial carcinoma. The important role of KAI1 playing in endomet rial carcinoma may be related to PR.The absence of KAI1 , PR and ER expressions is closely correlated with the progression , treatment andprognosis of endometrial carcinoma.