p16、p53和rasp21蛋白在子宫内膜癌组织中表达的研究

目的研究p16、p53和rasp21蛋白在子宫内膜癌中的表达及与雌激素受体（ER）和孕激素受体（PR）表达的关系，探讨子宫内膜癌发生、发展过程中多因素、多阶段的异常改变。方法应用免疫组化SABC法检测21例正常子宫内膜、19例子宫内膜上皮内瘤样病变（EIN）及45例子宫内膜癌中p16、p53、rasp21蛋白、ER和PR的表达情况。结果子宫内膜癌中p16蛋白的阳性表达率低于正常子宫内膜（P〈0．01）；正常子宫内膜中p53和rasp21蛋白阳性表达率低于子宫内膜癌（P〈0．05，P〈0．01）和EIN（P〈0．05），其表达与子宫内膜癌的临床分期、肌层浸润及组织分级有关（P〈0．05）。子宫内膜癌中，rasp21蛋白与ER、PR的表达呈负相关（r=-0．4575，r=-0．4240）。结论p16、p53和rasp21基因均参与子宫内膜癌的发生，rasp21蛋白的异常改变是子宫内膜癌发生的早期事件，并与ER和PR有协同作用，为子宫内膜癌恶性进展和预后的不利因素。

Study on the Expression of p16,p53 and rasp21 Proteins in Endometrial Carcinoma

Objective To study the expression of p16 ,p53 and rasp21 proteins in endometrial carcinoma and the relationship with estrogen receptor（ER） and progestogen receptor（ PR）, and demonstrate the stepwise abnormalities of multiple factors in the carcinogenesis and development of endometrial carcinoma. Methods The expression of p16,p53,rasp21 ,ER and PR in 21 cases of normal endometrium, 19 cases of endometrial intraepithelial neoplasia（EIN） and 45 cases of endometrial carcinoma were examined by immunohistochemistry SABC method. Results The positive expression rates of pl6 protein in normal endometrium were higher than that in endometrial carcinoma（ P 〈0.01 ） ;The positive expression rates of p53 and rasp21 protein in normal endometrium were lower than that in endometrial carcinoma （ P 〈 0. 05, P 〈 0. 01 ） and EIN （ P 〈 0.05 ） ; The expression of p53 and rasp21 protein showed significant correlation with clinical stages,myometrial invasion and histological grade of endometrial carcinoma. In endometrial carcinoma, the expression of rasp21 had negative correlation with ER and PR （ r = - 0. 4575, r = -0.4240）. Conclusions p16,p53 and rasp21 proteins might play some roles in the carcinogenesis of endometrial carcinoma. The abnormality of rasp21 protein is the early stage of carcinogenesis and the negative factor of progression and prognosis of endometrial carcinoma with ER and PR.