HIF1α、Glut1在子宫内膜癌中的表达及其临床意义

目的:探讨HIF1α、G lut1在子宫内膜癌中的表达及其临床意义,并分析两者的相关性。方法:用免疫组化S-P法检测15例正常子宫内膜、17例不典型增生子宫内膜、45例子宫内膜癌组织中HIF1α、G lut1的表达。结果:HIF1α、G lut1在子宫内膜癌和不典型增生子宫内膜中的阳性率明显高于正常子宫内膜,差异有统计学意义(P<0.05)。在子宫内膜癌组织中HIF1α蛋白阳性表达率与组织病理学分级、手术病理分期无关(P>0.05),但与肌层浸润深度和淋巴结转移有关,差异有统计学意义(P<0.05);G lut1随病理组织学分级的增加、手术病理分期的进展、肌层浸润深度的加深和淋巴结转移,其阳性率逐渐上升,差异有统计学意义(P<0.05);HIF1α蛋白、G lut1蛋白表达呈正相关(r=0.741,P=0.000)。结论:HIF1α、G lut1蛋白的异常表达与子宫内膜癌的发生、发展有一定的关系。     

子宫内膜癌中Maspin的表达及其与雌激素受体表达的相关性研究

目的:检测Maspin蛋白在正常子宫内膜、不典型增生及内膜癌组织中的表达,及其与雌激素受体(ER)表达的关系,探讨Maspin在子宫内膜癌发生中的作用及其作用机制。方法:免疫组化SP法检测40例子宫内膜腺癌、18例不典型增生及10例正常子宫内膜(对照组)中Maspin蛋白的表达及其与子宫内膜癌患者临床病理特征和ER蛋白表达的关系。结果:Maspin阳性表达在正常子宫内膜组最高(9/10,90%),高于内膜不典型增生组(10/18,55.6%)和内膜癌组(17/40,42.5%),差异有统计学意义(P<0.05),在内膜癌中FIGOⅠ期的表达(13/20,65.0%)明显高于Ⅱ~Ⅲ期(4/20,20.0%;P<0.05),无淋巴结转移者(17/34,50.0%)明显高于有淋巴结转移者(0/6;P=0.030),但与组织学分级及肌层浸润程度无关(P>0.05)。ER在正常子宫内膜、内膜不典型增生及内膜癌组织的阳性表达率分别为(10/10,100.0%)、(13/18,72.2%)和(20/40,50.0%),各组间差异有统计学意义(P<0.05);内膜癌组织中FIGOⅠ期的表达(14/20,70.0%)明显高于Ⅱ~Ⅲ期(6/20,30.0%;P<0.05);内膜癌高、中、低分化组中ER表达率分别为(11/15,73.3%)、(8/18,44.4%)、(1/7,14.3%),组间差异有统计学意义(P<0.05);无淋巴结转移者(20/34,58.8%)明显高于有淋巴结转移者(0/6;P=0.020),肌层浸润≤1/2者(16/24,66.7%)明显高于肌层浸润>1/2者(4/16,25.0%;P<0.05)。子宫内膜癌中,Maspin的表达与ER的表达存在正相关关系(r=0.394,P<0.05)。结论:从正常子宫内膜、内膜不典型增生到内膜癌,Maspin蛋白表达逐渐降低,且其低表达与子宫内膜癌临床分期晚、淋巴结转移有关,并与ER蛋白表达呈一致性,提示Maspin蛋白的表达可能受雌激素调控,参与了子宫内膜癌发生发展和转移过程。     

子宫内膜癌中基质金属蛋白酶-9表达及其临床意义

目的研究基质金属蛋白酶(MMPs)-9在子宫内膜癌中的表达以及临床意义。方法对广州医学院第三附属医院1992-1997年收治的128例子宫内膜癌、30例不典型增生内膜及30例正常子宫内膜石蜡标本,应用免疫组织化学方法检测MMP-9蛋白表达情况。结果子宫内膜癌组织与子宫内膜不典型增生、正常子宫内膜组织相比,MMP-9蛋白的阳性表达率增加,差异有统计学意义(χ2=8.154,P<0.05)。MMP-9蛋白阳性表达与子宫内膜癌病理分级及淋巴转移有关(P<0.05)。结论 MMP-9蛋白在子宫内膜癌的浸润转移中起促进作用,可能与子宫内膜癌的预后不良有关。     

RECK、TFF2、ERβ在老年患者子宫内膜癌中的表达#br# 与预后转归的关联分析

【摘要】 目的　探讨老年子宫内膜癌患者RECK、TFF2、ERβ的表达及其对疾病的预后作用。方法　收集40例老年子宫内膜癌患者的术后标本（癌症组）与20例正常子宫内膜组织标本（对照组）,通过免疫组化检测RECK、TFF2、ERβ的蛋白表达。结果　癌症组RECK、TFF2、ERβ的阳性表达率分别为42.5%、47.5%和40.0%,均显著低于对照组（75.0%、80.0%和80.0%）（P<0.05）癌症组组织中RECK、TFF2阳性表达与临床病理分期、组织学分级、淋巴结转移和肿瘤复发密切相关（P<0.05）;ERβ的表达与组织学分级和淋巴结转移密切相关（P<0.05）,而与临床分期及肿瘤复发无相关性。结论 RECK、TFF2和ERβ在老年子宫内膜癌患者中表达各异,与老年子宫内膜癌的发生、发展密切相关,RECK和TFF2对老年子宫内膜癌预后评估具有参考意义。     

uPA、uPAR与p38在子宫内膜癌组织的表达及意义

目的:探讨尿激酶型纤溶酶原激活物(uPA)与其受体uPAR及丝裂原活化蛋白激酶p38在子宫内膜癌组织的表达及相关性,并结合临床病理特征分析其在子宫内膜癌浸润、侵袭转移过程中的作用。方法:采用免疫组织化学方法(PV-6000二步法)检测12例正常子宫内膜(对照组)、20例子宫内膜增生组织(内膜增生组)及50例子宫内膜癌组织(内膜癌组)中uPA、uPAR及p38的表达,并研究其相关性,分析探讨各因子与子宫内膜癌临床病理分期、组织学分级、组织学类型等的关系。结果:(1)内膜癌组患者uPA、uPAR、p38阳性表达率均显著高于内膜增生组及对照组,差异有统计学意义(P<0.05);内膜增生组与对照组差异无统计学意义(P>0.05);(2)内膜癌组患者uPA和uPAR、p38的表达与临床病理分期、组织学分级、肌层浸润深度及有无淋巴结转移有关,差异有统计学意义(P<0.05);而与患者病理类型不相关(P>0.05);(3)子宫内膜癌组织uPA与uPAR的表达呈正相关(r=0.389,P<0.05);uPA与p38的表达也呈明显正相关(r=0.353,P<0.05)。结论:uPA与uPAR在子宫内膜癌发生发展侵袭转移过程中起着协同作用,p38MAPK信号通路在此过程中可能参与调节uPA,促进癌细胞浸润转移,因此uPA、uPAR、p38可能成为推测子宫内膜癌预后的重要参考指标。     

雌激素膜受体GPR30在子宫内膜癌的表达及意义

目的:探讨雌激素膜受体GPR30在子宫内膜癌的表达及意义。方法:RT-PCR和免疫组织化学法检测子宫内膜癌组织和正常子宫内膜组织中GPR30mRNA和蛋白的表达,分析GPR30表达与临床病理的联系;免疫细胞化学分析GPR30蛋白在子宫内膜癌细胞系RL95-2(ER+)和KLE(ER-)的表达。结果:子宫内膜癌组织GPR30mRNA的表达水平显著高于正常子宫内膜组织(P<0.05);子宫内膜癌组织GPR30蛋白表达阳性率(21/30,70%)显著高于正常子宫内膜组织(5/17,29.41%)(χ2=7.232,P=0.007);肿瘤组织学分级越高,GPR30表达阳性率越高(P=0.003),GPR30表达与内膜癌分期、肌层浸润深度和腹水转移无关(P>0.05);ERα阳性的子宫内膜癌细胞系RL95-2和ERα阴性的细胞系KLE均表达GPR30。结论:雌激素膜受体GPR30于子宫内膜癌组织和子宫内膜癌细胞系均有表达,与肿瘤组织学高分级相关,提示GPR30可能在子宫内膜癌中发挥重要的作用。     

雌激素受体ERα36在子宫内膜癌组织中表达及临床意义的初步研究

目的:分析新型雌激素受体ERα36在子宫内膜癌组织中的表达与临床病理特征的关系。方法:免疫组织化学方法检测73例子宫内膜癌、20例正常子宫内膜、9例不典型增生子宫内膜组织切片ERα36的表达,并分析其与临床病理特征间的关系。结果:ERα36在子宫内膜癌组织中阳性表达率(32.9%,24/73)显著低于正常子宫内膜组织(85%,17/20)(P<0.01);ERα36阴性表达者较阳性表达者出现更多宫颈受侵(48.9%vs 20.8%,P<0.05);ERα36阳性表达者无疾病生存时间短于阴性表达者(P<0.01);ERα36表达与患者年龄、临床分期、组织学分级、肌层浸润、淋巴结转移和病理类型的差异无统计学意义(P>0.05);ERα36表达与ER、PR、PTEN、p53无显著相关性(P>0.05)。结论:ERα36在子宫内膜癌组织的表达明显低于正常子宫内膜组织;ERα36表达与ER无明显相关性,可能是子宫内膜癌预后的一个指标。     

去整合素基质金属蛋白酶19在子宫内膜癌组织中的表达及意义

目的探讨去整合素基质金属蛋白酶19(ADAM19)与子宫内膜癌的发生、发展、浸润及转移的关系。方法选择2002年2月至2010年8月在广西医科大学第一附属医院妇科行手术治疗的患者共81例为研究对象,采用免疫组织化学的检测方法测定50例子宫内膜癌组织,16例不典型增生子宫内膜组织以及15例正常增殖期子宫内膜组织中ADAM19的表达情况,并分析其表达与各种临床参数的关系。结果 ADAM19蛋白在正常子宫内膜组织、不典型增生子宫内膜组织和子宫内膜癌组织中的高表达率分别为26.7%、75.0%和64.0%。在子宫内膜癌组织中的ADAM19的表达明显高于正常子宫内膜,差异有统计学意义(P<0.05)。ADAM19的表达与子宫内膜癌的组织学分级、肌层浸润深度、患者是否绝经有关(P<0.05),与子宫内膜癌的临床分期、淋巴结转移无关(P>0.05)。结论 ADAM19与子宫内膜癌的发生发展相关。     

RECK、TFF2、ERβ在老年患者子宫内膜癌中的表达与预后转归的关联分析

目的探讨老年子宫内膜癌患者RECK、TFF2、ERβ的表达及其对疾病的预后作用。方法收集40例老年子宫内膜癌患者的术后标本(癌症组)与20例正常子宫内膜组织标本(对照组),通过免疫组化检测RECK、TFF2、ERβ的蛋白表达。结果癌症组RECK、TFF2、ERβ的阳性表达率分别为42.5%、47.5%和40.0%,均显著低于对照组(75.0%、80.0%和80.0%)(P0.05)癌症组组织中RECK、TFF2阳性表达与临床病理分期、组织学分级、淋巴结转移和肿瘤复发密切相关(P0.05);ERβ的表达与组织学分级和淋巴结转移密切相关(P0.05),而与临床分期及肿瘤复发无相关性。结论 RECK、TFF2和ERβ在老年子宫内膜癌患者中表达各异,与老年子宫内膜癌的发生、发展密切相关,RECK和TFF2对老年子宫内膜癌预后评估具有参考意义。     

E-钙黏素和β-连环素在子宫内膜癌组织中表达状况的研究

目的：探讨E-钙黏素和β-连环素的表达状况与子宫内膜癌的关系。方法：采用免疫组织化学SP法检测38例正常子宫内膜、36例不典型增生子宫内膜组织和65例子宫内膜癌中E-钙黏素和β-连环素的表达。结果：E-钙黏素和β-连环素在正常子宫内膜、不典型增生子宫内膜和子宫内膜癌组织的异常表达率逐渐增高（P＜0.05）。E-钙黏素的表达与子宫内膜癌的组织学分级、肌层浸润深度、手术-病理分期有关。β-连环素的表达与子宫内膜癌的组织学分级、手术-病理分期、淋巴结转移有关。结论：E-钙黏素和β-连环素在子宫内膜癌的发生发展中起重要作用,分析E-钙黏素、β-连环素在子宫内膜癌中的表达有助于评价肿瘤的恶性程度和转移能力,判断肿瘤的预后。     

子宫内膜癌γ-synuclein表达和血清CA125水平及与临床病理特征关系的研究

目的:研究乳腺癌基因1(γ-synuclein)表达和血清癌抗原125(CA125)水平及与子宫内膜癌临床病理特征的关系,探讨其在子宫内膜癌发生发展中的作用及对病情评估的意义。方法:采用免疫组化SP法检测50例子宫内膜样腺癌(子宫内膜癌组)、14例子宫内膜不典型增生(子宫内膜不典型增生组)、12例正常子宫内膜(对照组)组织中γ-synuclein的表达,用化学发光免疫分析法检测患者血清CA125的水平。结果:γ-synuclein阳性表达在子宫内膜癌组、子宫内膜不典型增生组及对照组间比较,差异有高度统计学意义(χ2=10.379,P<0.01),其中,γ-synuclein在子宫内膜癌组及子宫内膜不典型增生组中的阳性表达均显著高于对照组(P均<0.01)。在子宫内膜癌组γ-synuclein表达与临床分期、肌层浸润深度有关(P<0.05,P<0.01)。子宫内膜癌组血清CA125水平阳性率显著高于对照组及子宫内膜不典型增生组(χ2=7.040,P<0.01)。γ-sy-nuclein、血清CA125之间无相关性(r=0.201,P>0.05)。结论:γ-synuclein的表达与子宫内膜癌发生发展及侵袭有关,可能作为预后指标;血清CA125水平可能预示子宫内膜癌的恶性程度。     

G蛋白偶联雌激素受体在子宫内膜腺癌组织表达及其意义

目的探讨G蛋白偶联雌激素受体(GPER)在子宫内膜腺癌组织中发生发展的作用。方法选取2005年3月至2008年4月郑州大学第一附属医院病理科手术及活检标本的存档蜡块,采用免疫组织化学SP法检测55例子宫内膜腺癌、49例子宫内膜增殖症及10例正常增生期子宫内膜组织中GPER蛋白的表达,分析其与子宫内膜腺癌患者临床病理特征的关系。结果正常增生期子宫内膜组织、子宫内膜增殖症组织和子宫内膜腺癌组织中GPER蛋白的阳性表达率分别为20.0%、67.3%和81.8%,差异具有统计学意义(χ2=15.778,P<0.001)。子宫内膜增殖症中,简单型增生、复杂型增生及不典型增生内膜组织中GPER蛋白的阳性表达率分别为30.0%、70.0%和84.2%,差异具有统计学意义(χ2=8.864,P=0.012)。绝经后和未绝经子宫内膜腺癌组织中GPER的阳性表达率分别为89.7%和62.5%,差异具有统计学意义(χ2=3.977,P=0.046)。高分化和中、低分化子宫内膜腺癌组织中GPER的阳性表达率分别为71.4%和100%,差异具有统计学意义(χ2=5.196,P=0.023)。临床分期Ⅰ期和(Ⅱ+Ⅲ)期子宫内膜腺癌组织中GPER的阳性表达率分别为73.0%和100%,差异具有统计学意义(χ2=4.268,P=0.039)。有淋巴结转移和无淋巴结转移的子宫内膜腺癌组织中GPER的阳性表达率分别为66.7%和83.7%,差异无统计学意义(χ2=0.210,P=0.646)。在肌层浸润深度<1/2和≥1/2的子宫内膜腺癌组织中GPER的阳性表达率分别为75%和100%,差异无统计学意义(χ2=3.057,P=0.080)。结论 GPER与子宫内膜腺癌的发生、发展可能具有相关性。     

P27，P73和CyelinD1蛋白在子宫内膜癌中表达的相关性

目的：探讨P27,P73和CyclinD1在子宫内膜癌组织中的表达及其相关性。方法：采用免疫组化SP法对14例正常增殖期子宫内膜、19例不典型增生内膜以及43例子宫内膜癌组织中P27,P73和CyciinD1蛋白的表达进行研究。结果：在子宫内膜癌中。P27表达降低或缺失,P73和CycJinD1表达明显增高,与正常增殖期子宫内膜和不典型增生内膜相比差异有统计学意义（P〈0．05或P〈0．01）。P27的表达缺失、P73的过表达与组织学分级有关,CyclinD1的高表达与手术一病理分期有关。有肌层浸润者P27,P73和CyclinD1的表达与无肌层浸润者差异均有统计学意义（均P〈0．05）。有淋巴结转移者P73和CyclinD1均明显高表达。子宫内膜癌中,P27与CyclinD1呈负相关（R=-0．3627,P〈0．05）,P73与CyclinD1呈正相关（r=0．3923,P〈0．05）。结论：子宫内膜癌中P27表达缺失,P73和CyclinD1过度表达,联合检测可能成为子宫内膜癌高危人群早期筛查、判断内膜癌的生物学行为及评估预后的参考指标。     

子宫内膜癌雄激素受体表达及临床意义

目的:探讨子宫内膜癌组织中的雄激素受体(AR)的表达及其与临床病理特征和雌激素受体(ER)、孕激素受体(PR)表达的关系。方法:应用免疫组织化学SP法检测41例正常子宫内膜、18例不典型增生及116例子宫内膜癌组织中AR、ER、PR的表达。结果:①子宫内膜细胞普遍存在AR的表达,在正常子宫内膜、不典型增生子宫内膜、子宫内膜癌组织中阳性表达率逐渐增高,但差异无统计学意义(P=0.424)。②AR在子宫内膜癌中的表达随患者FIGO分期、组织病理分级的升高而下降(P=0.011;P=0.047),而与患者发病年龄、是否绝经、组织学类型、淋巴结有无转移、肌层有无浸润无明显关系(P>0.05)。③AR的表达与ER、PR的表达呈正相关(r=0.293,P=0.001;r=0.275,P=0.003)。结论:AR在子宫内膜癌的发生、发展中可能起重要作用,AR阳性表达者的生物学行为较好。     

Prognostic significance of DNA topoisomerase II-alpha (Ki-S1) immunoexpression in endometrial carcinoma

OBJECTIVE: In order to determine the significance of proliferative activity (PA) in endometrial carcinomas, we analysed the expression of cell cycle-related antigens in routinely processed tissue. MATERIALS AND METHODS: Serial sections of 113 endometrial carcinoma specimens were immunostained with the monoclonal antibody DNA Topoisomerase II-alpha (Ki-S1). In addition to Topoisomerase II-alpha (Ki-S1) staining, histologic type, International Federation of Gynecology and Obstetrics (FIGO) stage. FIMO grade, depth of myometrial invasion, tumor size, lymphovascular space invasion, serosal and/or adnexal involvement, lymph node metastasis, age and peritoneal cytology were evaluated as prognostic indicators. The median follow-up time was 23 (range, 1 to 126 ) months. RESULTS: FIGO stage, FIGO grade, tumor size, lymphovascular space invasion, lymph node metastasis, peritoneal cytology and Topoisomerase II-alpha (Ki-S1) expression all significantly influenced survival in univariate analyses (p < or = 0.05). In the Cox regression analysis, Topoisomerase II-alpha (Ki-S1), serosal and/or adnexal involvement, and lymph node metastasis expression were the only variables with independent prognostic impact (p < or = 0.05), whereas FIGO stage, FIGO grade, histologic type FIGO grade, depth of invasion, tumor size, lymphovascular space invasion, age and peritoneal cytology had no independent influence (p > 0.05). Topoisomerase II-alpha (Ki-S1) staining was significantly elevated in advanced (Stage II, III, IV) as opposed to early (Stage I) carcinomas (p < or = 0.05). CONCLUSION: The association with established prognosticators for endometrial carcinomas, and the results of uni- and multivariate analysis indicate that the additional evaluation of DNA Topoisomerase II-alpha (Ki-S1) peptide antibody (PA) is useful for classifying patients into subgroups with low and high risk of relapse which might help to individualize the therapeutic strategy in endometrial carcinomas.     

Endometrial tumor invasiveness is related to metalloproteinase 2 and tissue inhibitor of metalloproteinase 2 expressions

Matrix metalloproteinase (MMPs) expression has been linked to gynecological tumor aggressiveness. The objective of this study was to determine MMP-2, MMP-7, and MMP-9 and tissue inhibitors of metalloproteinases (TIMP)-1 and TIMP-2 expression in endometrial malignancies and their relation to clinical and histologic parameters. Formalin-fixed, paraffin-embedded tumor samples from 50 patients with endometrial carcinoma treated between 1999 and 2004 were stained with specific monoclonal antibodies. The tumors were grouped according to the FIGO classification. The staining results were compared to histologic and clinical data. Semiquantitative analysis of MMP and TIMP expression showed a significant difference in TIMP-2 expression according to the histologic subtype (P = 0.03) and also a trend towards a difference in MMP-9 expression (P = 0.05). MMP-2 expression increased and TIMP-2 expression fell as the histologic grade increased (P = 0.0007, P < 0.0001, respectively). MMP-2 expression correlated with lymph node metastasis (P = 0.04), while TIMP-2 expression correlated with the depth of myometrial invasion (P = 0.01), vasculolymphatic space involvement (P = 0.02), and lymph node metastasis (P = 0.0003). These results support the involvement of MMPs and TIMPs in endometrial tumor growth and progression. High MMP-2 and low TIMP-2 expression were the most potent markers of endometrial tumors with a high risk of local and distant spread.     

转化生长因子β1及其受体与子宫内膜癌发生及临床病理参数关系的探讨

目的 :探讨转化生长因子β1(transforminggrowthfactorβ1,TGFβ1)及其Ⅰ、Ⅱ型受体TGFβR Ⅰ、TGFβR Ⅱ与子宫内膜癌发生及临床病理参数的关系。 方法 :采用免疫组化多克隆抗体技术检测 30份正常子宫内膜癌组织、15份子宫内膜复合增生组织 (其中 9份有不典型增生 )、12份正常子宫内膜组织中TGFβ1及其受体TGFβR Ⅰ、TGFβR Ⅱ的表达。结果 :子宫内膜癌及复合增生组织中TGFβ1表达明显高于正常子宫内膜组织中者 (P<0 .0 1,P <0 .0 5) ,而前两者之间差异无显著性 (P >0 .0 5) ,且TGFβ1表达水平与子宫内膜癌肌层浸润深度呈正相关 (P <0 .0 5)。从正常子宫内膜、复合增生到子宫内膜癌组织中TGFβR Ⅰ、TGFβR Ⅱ表达逐渐下降甚至缺如 ,且两两之间差异均有显著性 (P <0 .0 5)。TGFβR Ⅰ、TGFβR Ⅱ均与肌层浸润深度呈负相关 (P <0 .0 5)。 结论 :TGFβ1过度表达可能促进子宫内膜癌的进展 ,可能是子宫内膜癌发生的早期现象 ,其负性调控的丧失与TGFβR Ⅰ、TGFβR Ⅱ表达下降或缺如有关。     

Glycoprotein CD44 expression in normal, hyperplasic and neoplastic endometrium. An immunohistochemical study including correlations with p53, steroid receptor status and proliferative indices (PCNA, MIB1)

PURPOSE OF INVESTIGATION: We have studied by immunohistochemistry the presence and localization of CD44, estrogen and progesterone receptors, p53 and proliferative associated indices (MIB1, PCNA) in archival endometrial tissue, in order to determine their diagnostic and prognostic value as well as the possible correlations between them. METHODS: We examined 186 samples of endometrial tissue (100 endometrial carcinomas of endometrioid type, 40 cases of hyperplasia and 46 of normal endometrium). Patient records were examined for FIGO stage, grade, and depth of myometrial invasion, histology, and lympho-vascular space invasion. RESULTS: Strong membranous immunostaining (> 10% of neoplastic cells) was observed in 45% of the carcinomas. A statistically significant correlation was found in the expression of protein in stromal cells, when compared with epithelial cells (p < 0.0001). Immunohistochemical expression of CD44 was significantly lower in cancer cases than in normal endometrium, mainly in the secretory phase (p < 0.0001). CD44 positive cases by immunohistochemistry failed to show any statistical correlation with tumor grade or with vessel invasion. The expression of the protein was lower in FIGO Stage II compared with Stage I (p = 0.03). A positive relation of CD44 expression with progesterone receptor status (p = 0.02) was detected. CD44 expression was also positively associated with the proliferation associated with the proliferative index MIB1 (p = 0.001). CONCLUSION: CD44 is closely related to the secretory phase of the normal menstrual cycle and its expression is decreased in hyperplasia (simple or complex with or without atypia) and in cancer cases. These observations suggest that decreased CD44 expression might be functionally involved in the multiple mechanisms of the development and progression of endometrial lesions.     

Angiogenesis, p53, and bcl-2 expression as prognostic indicators in endometrial cancer: comparison with traditional clinicopathologic variables.

We investigated the relation of expression of tumor-suppressor gene product p53, apoptosis-regulator gene product bcl-2, and CD34 (as a measure of microvessel density [MVD]) with traditional clinicopathologic prognostic variables in endometrial carcinoma (histologic type, grade, depth of myometrial invasion, angiolymphatic invasion, lymph node involvement). In specimens from 63 patients with endometrial carcinoma, the mean MVD (64.38+/-28.71 microvessels per 200x field) was not related to any clinicopathologic variables. Nuclear p53 expression was detected in 15 (23.8%) patients and was higher in nonendometrioid carcinomas (p<0.05) and in tumors with increasing histologic grade (p<0.001). Cytoplasmic bcl-2 staining was seen in 79.3% of the tumors. There was a negative correlation between bcl-2 expression and histologic type and tumor grade (p<0.05). In survival analysis, patient age, FIGO stage, high expression of p53, low expression of bcl-2, and high and intermediate MVD values were found to be the most significant prognostic indicators of survival (p<0.05). In multivariate regression analysis, FIGO stage and low bcl-2 expression were found to be the only independent indicators of prognosis (p<0.05).