m-TOR、PTEN等相关蛋白在子宫平滑肌瘤与平滑肌肉瘤中的表达及意义

目的 研究相关蛋白在子宫平滑肌瘤与子宫平滑肌肉瘤患者组织中的表达,并探讨其在肿瘤发生、治疗与预后监测中的潜在价值。 方法 收集绍兴市人民医院2006年11月—2016年1月进行手术的14例子宫平滑肌肉瘤(平滑肌肉瘤组)与65例子宫肌瘤(子宫肌瘤组)患者标本。免疫组化方法测定标本的雌激素受体(ERα、ERβ)、孕激素受体(PR、PR-b)、磷酸酶及张力蛋白同源基因(PTEN)、雷帕霉素靶蛋白(m-TOR)、低氧诱导因子1α(HIF-1α)、葡萄糖转运蛋白1(GLUT-1)、细胞增殖核抗原(Ki-67)的表达。采用成组t检验或Mann-Whitney检验比较2组肿瘤各蛋白指标表达的差异,对m-TOR的表达强度行χ2检验。 结果 平滑肌肉瘤患者组织HIF-1α(P=0.011)、Ki-67(P<0.001)、GLUT-1(P=0.028)、m-TOR(P=0.019)表达显著高于子宫肌瘤组;而子宫肌瘤组ERα(P<0.001)、PR(P<0.001)、PTEN(P=0.002)的表达显著高于平滑肌肉瘤组;平滑肌肉瘤组m-TOR中高度表达者显著多于子宫肌瘤组(χ2=11.695,P=0.001);其余蛋白表达差异无统计学意义。 结论 ERα、GLUT-1在子宫平滑肌肉瘤中的表达差异为术前利用PET鉴别平滑肌肉瘤患者的可行性提供了理论依据,m-TOR、PTEN等蛋白在肉瘤与肌瘤中的表达差异对指导治疗及研究预后具有较大意义。 

The significance of m-TOR,PTEN and other related proteins expression in leiomyoma and leiomyosarcoma

Objective To investigate the expression of related proteins in leiomyoma and leiomyosarcoma,and discuss the potential value in tumor genesis, treatment and prognosis monitoring in leiomyosarcoma. Methods Between 2006 and 2016, 14 leiomyosarcoma and 65 leiomyomas were collected, and all patients underwent operation and confirmed by pathology. ERα(Estrogen receptor α), ERβ, PR(progesterone receptor), PR-b, PTEN(Phosphatase and tensin homolog deleted from chromosome 10), m-TOR(mammalian target of rapamycin), HIF-1α(hypoxia induced factor 1α), GLUT-1(glucose transport proteins-1) and Ki-67(nuclear-associated antigen) were determined by immumo-histochemical staining in leiomyoma and uterine sarcoma tissue respectively. The difference between the groups about the expression of proteins were analyzed. Student's t test and Mann-Whitney test were performed in comparison between groups. The expression of m-TOR was tested by chi square. Results An increased immune-expression of HIF-1α(P=0.011), Ki-67(P<0.001), GLUT-1(P=0.028), m-TOR(P=0.019) and decreased expression of ERα(P<0.001), PR(P<0.001), PTEN(P=0.002) were observed in leiomyosarcoma as compared to leiomyoma. The expression of other proteins showed no significant difference. Chi square showed more leiomyosarcoma patients with higher expression of m-TOR(χ2=11.695,P=0.001)while other protein expressions exhibited no significant differences. Conclusion The different expression of ERα, GLUT-1 in leiomyoma and leiomyosarcoma provides a theoretical basis for noninvasive identification of leiomyosarcoma, and m-TOR, PTEN and other related proteins in the two tumors may provide potential therapeutic target and maybe an effective prognostic biomarker.