子宫内膜样腺癌组织P63和P53蛋白的表达及其临床病理学意义

目的:探讨p63和p53基因在子宫内膜样腺癌(endometrial adenocarcinoma,EC)发生发展中的作用及其与EC临床病理特征的关系。方法:采用免疫组化EnVision法检测65例EC、25例子宫内膜增生过长(endometrial hyperplasia,EH)及15例正常增生期子宫内膜(benign proliferative endometrium,BPE)中P53和P63蛋白的表达情况。结果:P63蛋白在EC组中的阳性率为78.5%(51/65),与EH组(4/25,16%),BPE组(1/15,6.7%)比较,差异均有统计学意义(P<0.001);P63的表达与EC的组织学分级、手术病理分期和肌层浸润深度均无关(P>0.05)。P53蛋白在EC组中的阳性率为36.9%(24/65),明显高于EH(2/25,8%)组和BPE组(0/15)(P<0.01);P53的表达与EC的手术病理分期和肌层浸润深度显著相关(P<0.01),而与组织学分级无关(P>0.05)。P53和P63在子宫内膜样腺癌中的表达呈正相关(r=0.246,P=0.048)。结论:突变型p53和p63可能共同参与子宫内膜样腺癌的发生、发展,p63在EC的发生中可能起癌基因作用,其阳性表达可能是子宫内膜样腺癌发生的早期事件。

Expressions of P63 and P53 in Endometrioid Adenocarcinoma and Their Clinicopathologic Significance

Objective:To study the roles of p63 and p53 in tumorigenesis and development of endometrial adenocarcinoma(EC) and their correlation with clinicopathologic features.Methods:The expressions of P63 and P53 were detected by the immunohistochemical stain in 65 cases of EC,25 cases of endometrial hyperplasia(EH) and 15 cases of benign proliferative endometrium(BPE).Results:The positive rate of P63 was 78.5%(51/65) in EC,there was a significant difference between EC and EH(4/25,16%) or BPE(1/15,6.7%),(P<0.001).The expression of P63 was not associated with the histological grade,stage and depth of myometfial invasion in EC(P>0.05).The positive rate of P53 was 36.9%(24/65) in EC,and the expression was significantly higher than those in EH(2/25,8%)and BPE(0/15)(P<0.01).The expression of P53 was associated with the stage and depth of myometrial invasion in EC(P<0.01),but was not associated with the histological grade(P>0.05).There was a significantly positive correlation between P63 and P53(r=0.246,P=0.048).Conclusions:Mutant p53 and p63 are involved in carcinogenesis of EC,and there may be an assistant role between p53 and p63.p63 may be an oncogene in tumorigenesis of EC,and its over-expression may be an early event in development of endometrial adenocarcinoma.