端粒酶hTERT在子宫内膜癌中的表达及意义探讨

目的　探讨端粒酶hTERT基因蛋白表达与子宫内膜癌发生发展的关系及对内膜癌诊断、预后的临床意义。方法　采用免疫组化方法对 33例子宫内膜癌、36例绝经期子宫内膜及 36例子宫内膜增生过长标本进行端粒酶hTERT、雌激素受体ER及孕激素受体PR检测 ,同时与正常增殖期 ,分泌期子宫内膜进行对照。结果　hTERT在子宫内膜癌中的表达强度明显高于其他内膜病变 ,有显著性差异 (P<0 .0 5 ) ;hTERT在子宫内膜癌中的表达与肌层浸润及临床分期呈正相关 ;与病理分级及雌、孕激素受体ER ,PR呈负相关。结论　上述结果提示端粒酶hTERT在子宫内膜癌的发生发展中可能起重要作用 ,端粒酶hTERT与ER ,PR的联合检测可能成为子宫内膜癌判断预后的一个指标。     

c—myc和p16在子宫内膜癌中的表达及临床意义

目的 研究癌基因c-myc和抑癌基因p16在子宫内膜癌中的表达及临床意义。方法采用免疫组化(S-P)法检测10例增生子宫内膜、22例子宫内膜不典型增生、42例子宫内膜癌中c-myc和p16基因表达,并分析其与子宫内膜癌发生、发展及预后的关系。结果 (1)c-myc在子宫内膜癌中的阳性率为26.19％(11/42),显著高于增生子宫内膜(均显阴性)及子宫内膜不典型增生(4.55％;P<0.05,P<0.05);c-myc在子宫内膜癌中的表达与组织学分级、临床分期显著相关(P<0.01,P<0.05),但与肌层浸润深度及淋巴结转移无关(P>0.05,P>0.05)。(2)p16在子宫内膜癌的阳性率为69.05％(29/42),显著低于增生子宫内膜(100％,10/10)及子宫内膜不典型增生(90.91％,;P<0.05,P<0.05);p16的表达与组织学分级、肌层浸润深度、临床分期及淋巴结转移显著相关(P<0.05,P<0.05,P<0.01,P<0.05)。结论 癌基因c-myc和抑癌基因p16可能在子宫内膜癌的发生、发展及转归中起着重要作用。     

Immunohistochemical detection of estrogen receptors on paraffin sections of normal, hyperplatic and carcinomatous endometrium.

The present study is the first dealing with the demonstration of estrogen receptors (ER) in up to 8-year-old paraffin blocks of endometrial curettage samples routinely fixed in 10% formalin. The Mab ER-ICA was used in a modified peroxidase-antiperoxidase method after pretreatment of paraffin sections with pronase. Eleven cases with proliferative, 11 cases with secretory endometrium, 20 cases with adenocystic, 21 with adenomatous hyperplasia and 27 endometrial adenocarcinomas were tested. The two main parameters, namely the percentage of ER-positive cells and the intensity of the immunostaining, were higher in the proliferative phase followed in a declining sequence by adenocystic hyperplasia, adenomatous hyperplasia, adenocarcinomas and the secretory phase of endometrium. Interestingly, the intensity of the immunostaining showed a positive relationship to the percentage of ER-positive cells (r = 0.93, p less than 0.001). It seems that the immunohistochemical demonstration of ER in paraffin sections of uterine specimens is an easy and reliable method for the mapping of the heterogeneous expression of ER and their comparative study with the well preserved histopathological features even in old archival paraffin-embedded material.     

Bcl-2和Bax蛋白在正常、增生和恶性子宫内膜中的表达

Objective To investigate the expression of Bcl-2 and Bax proteins in normal, hyperplastic, and malignant endometrium. Methods Endometrial tissues were obtained from 14 proliferative endometrial samples; simple (n=30) and complex hyperplasia without atypia (n=13); complex hyperplasia with atypia (n=20) and endometrial adenocarcinoma (n=17). The expression of Bcl-2 and Bax proteins was detected by using immunohistochemical staining with appropriate antibodies. Results The intensity of Bcl-2 staining was gradually increased from proliferative to simple and complex hyperplasia, but it was gradually decreased from atypia hyperplasia to endometrial adenocarcinoma (P<0.05). The intensity of Bax staining was gradually increased from proliferative endometrium to simple and complex hyperplasia, but in atypia hyperplasia it was obviously lower than simple hyperplasia, the ratio of Bcl-2: Bax staining intensity was changed with the endometrium from proliferative, hyperplastic endometrium to endometrial adenocarcinoma. The ratio of Bcl-2: Bax staining intensity was obviously decreased in atypia hyperplasia and endometrial adenocarcinoma. Conclusion The survival time of the cells in hyperplasia expressing Bcl-2 might be prolonged. Neoplastic cells in atypia hyperplasia and adenocarcinoma might show a decreased expression of Bcl-2 and Bax, suggesting that Bcl-2 and Bax might be important indexes and prognosis factors and the expression of Bcl-2 and Bax might be correlated with carcinogenesis in the uterine endometrium of humans.     

子宫内膜癌DNA错配修复基因hMSH2表达的研究

目的：探讨DNA错配修复基因hMSH2的表达与子宫内膜癌的关系.方法：选取天津医科大学总医院1981年1月～2001年12月间住院手术子宫内膜癌104例和正常子宫内膜35例（增生期17例，分泌期18例）及8例子宫内膜非典型增生组织标本，采用免疫组化SABC法检测组织中hMSH2基因蛋白表达情况，并对hMSH2蛋白表达与子宫内膜癌临床病理特征的关系进行分析.结果：子宫内膜癌、子宫内膜非典型增生、正常子宫内膜增生期和分泌期hMSH2表达缺失率分别为68.3%、4/8（50.0%）、5.9%和5.6%，子宫内膜非典型增生和子宫内膜癌组织hMSH2表达缺失率无明显差异（P=0.294），但明显高于正常增生期及分泌期子宫内膜 子宫内膜样腺癌、腺鳞伴鳞状上皮分化、透明细胞癌和浆液性癌hMSH2表达缺失率分别为73.3%、2/8、2/4和1/2，子宫内膜样腺癌中hMSH2基因表达缺失率明显高于其它组织学类型（P=0.035）.hMSH2表达阴性和阳性者5年生存率分别为80.0%、52.0%，10年生存率分别为78.0%、32.0%，hMSH2基因表达阴性者生存率明显高于阳性表达者.结论：子宫内膜癌和子宫内膜非典型增生中hMSH2基因表达缺失率相似，hMSH2表达缺失可能与子宫内膜癌发生早期有关.hMSH2基因表达缺失与子宫内膜癌组织学类型中的子宫内膜样腺癌有关，hMSH2基因表达缺失者预后较好.     

Metalloproteinase-2, -7 and -9 and tissue inhibitor of metalloproteinase-1 and -2 expression in normal, hyperplastic and neoplastic endometrium: a clinical-pathological correlation study.

BACKGROUND: Matrix metalloproteinases (MMPs) and their inhibitors are key-players in extracellular matrix and basement membrane degradation, and are involved in both physiological and malignant processes. The aim of this study was to examine MMP-2, -7 and -9 and TIMP-1 and -2 expression in normal, hyperplastic and malignant endometrium, and their relation to clinical and histological prognostic factors. MATERIALS AND METHODS: We performed qualitative and semi-quantitative immunohistochemical analysis of 20 samples of normal endometrium (10 in the proliferative phase, 10 in the secretory phase), 39 samples of hyperplastic endometrium (17 without atypia and 22 with atypia) and 38 samples of endometrioid carcinoma, by using specific monoclonal antibodies. RESULTS: In normal endometrium, epithelial expression of MMP-2 (P = 0.0007), MMP-7 (P = 0.0002) and TIMP-2 (P = 0.0004) was increased during the proliferative phase of the menstrual cycle. MMP-2 expression correlated negatively with TIMP-2 expression (P = 0.001, rho = 0.702). Endometrial stromal cells in the secretory phase showed strong MMP-2 expression (P = 0.004) and weak MMP-7 (P = 0.001) and TIMP-1 expression (P = 0.01). In hyperplastic endometrium, the presence of atypia was associated with lower TIMP-2 expression (P = 0.005) and was also associated with a trend towards higher MMP-2 expression. Endometrial stromal cell expression of MMP-2, -7 and -9 and TIMP-1 and -2 did not differ between hyperplastic endometrium with and without atypia. A gradient of MMP-2 and -9 expression was observed from hyperplastic endometrium to endometrial carcinomas. In endometrial carcinomas, MMP-2 expression increased (P = 0.0004) and TIMP-2 expression decreased (P = 0.0005) with the histological grade. TIMP-2 expression correlated with myometrial invasion (P = 0.005), lymphovascular space involvement (P = 0.008) and lymph node involvement (P = 0.007). CONCLUSION: These results support the involvement of MMPs and TIMPs in endometrial carcinogenesis. Strong MMP-2 and weak TIMP-2 expression were the most potent markers of endometrial malignancies with a high risk of local and distant spread.     

Significantly decreased P27 expression in endometrial carcinoma compared to complex hyperplasia with atypia (correlation with p53 expression)

P27 expression was examined on paraffin-embedded specimens in proliferative, secretory, hyperplastic and neoplastic human endometrium by immunohistochemistry. The results of p27 immunoreactivity in endometrial carcinomas were compared with clinicopathological indicators as well as with p53 expression. Thirty-eight cases of endometrial carcinoma, 30 normal functional (15 proliferative, 15 secretory), 24 hyperplastic endometrium (12 without atypia, 12 with atypia) specimens were studied by using monoclonal p27 and p53 antibodies. The streptavidin-biotin-peroxidase detection system was used and the intensity and the distribution of immunoreactivity was evaluated semiquantitatively. p27 expression was present both in the proliferative and secretory phases; the expression being stronger in the secretory period. In complex hyperplasia with atypia, p27 expression was even higher and it was significantly reduced in the endometrial carcinoma group (p<0.05). No significant correlation was found between p27 expression and any of the clinicopathologic prognostic parameters (p>0.05). Nuclear p53 expression was detected in 13 (34.2%) patients with endometrial carcinoma and was higher in non-endometrioid carcinomas and in tumors with increasing FIGO grade (p<0.05). High expression of p53 was not found to be a significant prognostic indicator of survival (p> 0.05). No p53 expression was detected in the endometria with proliferation, secretion or hyperplasia either simple without atypia or complex with atypia. Surprisingly, tumors with absent/low p27 expression showed absent/low p53 expression. Our data suggest that p27 is necessary to control the proliferation of endometrium and its loss of expression seems to play a role in some aspects of endometrial carcinogenesis.     

子宫内膜息肉细胞凋亡及增殖的研究

 目的　从细胞凋亡与增殖方面探讨子宫内膜息肉的发病机制,解释其临床症状。方法　免疫组织化学方法与计算机图像分析系统定量检测bcl-2、Bax、Ki-67表达,计算Bax／bcl-2 比值。对比分析增殖期息肉（40例）与增殖期内膜（40例）之间、分泌期息肉（40例）与分泌期内膜（40例）之间表达情况,腺上皮与间质分别对照。结果　Ki-67在不论是增殖期还是分泌期腺上皮细胞中,息肉组显著高于对照内膜组（P＜0.01）,而在间质中息肉组低于对照内膜组（P＝0.000）。Bax在增殖期息肉腺上皮的表达高于增殖期内膜腺上皮。bcl-2在分泌期息肉与分泌期内膜之间不论是腺上皮还是间质,均是前者高于后者。不管是分泌期还是增殖期,间质Bax／bcl-2在息肉组显著低于内膜组。结论　子宫内膜息肉的发生可能与腺上皮细胞过度增生及间质细胞凋亡受限有关。息肉增殖、凋亡及脱落与周围内膜不同步,且息肉内部本身增殖、凋亡不同步,两个不同步导致不规则、经间期出血的临床表现。     

Expression of uteroglobin in normal and carcinogenic endometrium and influence of hormone replacement therapy

Uteroglobin, first reported in 1968 as a steroid secreted in rabbit uterine fluid during early pregnancy, is a progesterone-regulated and progesterone-binding protein. There is evidence that indicates that uteroglobin is inversely correlated to neoplastic growth but its role to endometrial carcinogenesis is not known. Therefore we analyzed the expression of uteroglobin in 13 normal endometrium, 19 hyperplasia and 21 endometrial carcinoma samples and the relation to estrogen receptor-alpha (ER-alpha) and progesterone receptor (PR) by immunohistochemistry and Western blotting. We also analyzed the expression of uteroglobin in 15 menopausal women who received hormone replacement therapy (HRT). The expression of uteroglobin was higher during the secretory phase than in the proliferative phase; however, it was detected in endometrial hyperplasia as weakly as in the proliferative phase and decreased according to the loss of differentiation in endometrial carcinoma. The results were basically in accord with those for PR; however, the expression of uteroglobin was weak, though PR was most detected in endometrial hyperplasia. In menopausal endometrium, the group treated with estrogen plus progesterone exhibited higher expression of uteroglobin than the group treated only with estrogen. The evidence suggests that uteroglobin expression is regulated by progesterone in the normal endometrium but that the regulation by PR is lost in endometrial hyperplasia and carcinoma according to acquirement of tumorigenesis and that estrogen plus progesterone therapy reduces the risk for endometrial carcinoma by restoring uteroglobin.     

细胞核增殖相关抗原Ki67在子宫内膜病变中的表达

目的：研究Ki67抗原在子宫内膜病变中表达的规律及其在子宫内膜癌的发生和预后评估的临床价值。方法：用免疫组化（SP）法检测子宫内膜增殖症及非典型增生各30例，子宫内膜癌90例；对照组30例，其中包括增生期及分泌期子宫内膜各15例，观察Ki67抗原在不同内膜病变及正常内膜中的阳性表达率。结果：Ki67抗原在分泌期内膜中几乎没有表达，在增生期内膜中有弱表达；在增殖症及非典型增生中有表达，但与对照组比较，无统计学意义（P〉0．05），且两者之间比较，亦无统计学意义（P〉0．05）；在子宫内膜癌组织中表达明显增高，显著高于良性病变组和对照组（P〈0．01）。而且Ki67抗原的阳性率随着临床分期及细胞分化级别的升高及淋巴转移的存在而增加。结论：Ki67抗原与子宫内膜癌发生密切相关．抗原过度表达提示子宫内膜癌患者预后不良。     

Total sialic acid content in endometrial cancer tissue in relation to normal and hyperplastic human endometrium

The aim of this study was to measure the total sialic acid (TSA) content in endometrial cancer tissue and to assess its relationship to clinicopathologic features of the malignancy. Tissue TSA content was measured in 42 women with endometrial cancer, 14 women with endometrial hyperplasia, and 45 women with normal endometrium in the proliferative phase (n = 16) and secretory phase (n = 29) of the menstrual cycle using the Warren procedure. The mean TSA content in endometrial cancer (2.16 micromol/gm) was significantly higher in comparison to normal endometrium in both proliferative (1.23 micromol/gm) and secretory (1.51 micromol/gm) phases. TSA content in the hyperplastic endometrium (1.56 micromol/gm) was higher as compared to the normal endometrium, but the differences were not statistically significant. An increased TSA content in the neoplastic endometrium in relation to the normal endometrium supports the view that the development of endometrial cancer is associated with the increasing content of sialic acid in the tumor tissue.     

ezrin和flt-1在子宫内膜癌中的表达及其意义

目的探讨膜细胞骨架连接蛋白ezrin、血管内皮生长因子受体1（flt-1）在子宫内膜癌中的表达及其与临床病理参数之间的关系.方法采用免疫组化方法检测79例子宫内膜癌和12例转移灶组织中ezrin和flt-1蛋白的表达,选择不典型增生14例,单纯、复合性增生20例和正常子宫内膜增生期15例作为对照.结果 ezrin蛋白在正常内膜,单纯、复合性增生, 不典型增生和内膜癌四组间的差异有显著性（P＜0.01）,不典型增生组ezrin的表达高于单纯、复合性增生,内膜癌高于不典型增生.多数正常和增生腺上皮细胞不表达ezrin,而大多数不典型增生和内膜癌细胞表达ezrin,且为细胞浆和细胞膜弥散着色,差异有显著性.内膜癌中,深肌层浸润组ezrin的表达高于浅肌层或无肌层浸润组（P＜0.05）.flt-1在不典型增生中的表达高于正常内膜,内膜癌中flt-1的表达强度随组织学分级升高而降低（P＜0.05）.内膜癌中ezrin与flt-1的表达间无明显相关性,ezrin与雌激素受体（ER）间存在负相关.结论 ezrin可能参与了子宫内膜癌的发生和演进过程.     

Expression of steroid receptor coactivators and corepressors in human endometrial hyperplasia and carcinoma with relevance to steroid receptors and Ki-67 expression

BACKGROUND: To examine the steroid hormone dependent growth mechanism of human endometrial hyperplasia and carcinoma, expression levels of steroid receptor cofactors, such as coactivators (steroid receptor coactivator 1 [SRC-1] and p300/cyclic AMP-response element-binding protein (p300/CBP]) and corepressors (nuclear receptor corepressor [NCoR] and silencing mediator for retinoid and thyroid-hormone receptors [SMRT]), were investigated. METHODS: The expression levels of cofactors were examined immunohistochemically using 20 samples of normal endometria, 36 samples of hyperplastic endometria, and 58 of malignant endometria and were compared with the expression levels of estrogen receptor (ER), progesterone receptor (PR), and a proliferation marker, Ki-67. RESULTS: In samples of normal endometria, the expression of coactivators was observed diffusely in glandular cells in the proliferative phase, with a mean positivity index (PI) of 81.8 for SRC-1 and 91.3 for p300/CBP, whereas expression levels decreased in endometrial hyperplasia (PI: SRC-1, 58.9; p300/CBP, 83.8) and endometrial carcinoma (PI: SRC-1, 45.0; p300/CBP, 55.4). In endometrial hyperplasia, there was a significant correlation between the expression of ER and SRC-1 or p300/CBP. In contrast, there were no significant statistical or topologic correlations between the expression of coactivators and the expression of ER/PR in endometrial carcinoma. The expression of corepressors generally was limited, except for elevated expression of NCoR in endometrial hyperplasia (PI, 23.8). CONCLUSIONS: The current study showed that expression levels of the steroid receptor coactivators SRC-1 and p300/CBP were reduced in endometrial carcinoma compared with normal and hyperplastic endometrium. In addition, topologic coexpression of both coactivators and ER/PR was lost in endometrial carcinoma. Accordingly, limited response to sex steroids in patients with endometrial carcinoma may be ascribed to the dissociation of cofactors and ER/PR.     

增殖细胞核抗原在子宫内膜病变组织中的表达及临床意义

目的:研究增殖细胞核抗原(PCNA)在子宫内膜病变中的表达规律及其在子宫内膜癌的发生、发展及估计患者预后中的临床价值。方法:用免疫组化SP法检测子宫内膜增殖症30例、非典型增生30例、子宫内膜癌90例,共150例作为实验组,分泌期及增生期内膜各30例作为对照组,观察PCNA在不同内膜病变及正常内膜中的阳性表达率。结果:PCNA在正常子宫内膜、子宫内膜增殖症、非典型增生阳性表达率依次呈升高趋势,子宫内膜增殖症与增生期内膜比较差异无统计学意义,P>0.05。而在非典型增生内膜和内膜癌组织中,PCNA表达明显增高,显著高于子宫内膜增殖症和增生期内膜,差异有统计学意义,P<0.01;且PCNA的阳性率与临床分期、细胞分化程度及淋巴转移有关。结论:PCNA与子宫内膜癌的发生和发展密切相关,PCNA表达对于子宫内膜癌的诊断和判断预后有重要意义。     

血脂异常与子宫内膜癌的相关性分析

目的:回顾性分析子宫内膜癌患者中血脂代谢异常发病情况并探讨血脂代谢异常与子宫内膜癌发病风险的相关性。方法:收集2010年至2014年就诊于新疆医科大学第一附属医院的未经过放疗及化疗的且 经病理确诊为雌激素依赖型子宫内膜癌的病例81例。另以子宫内膜正常组,子宫内膜增生组作为对照组、各组分别56例,收集患者和对照者一般资料,既往史,月经史,婚育史,用药史,家族史(包括家族肿瘤史),生化血脂结果,病理结果。结果:子宫内膜正常组、子宫内膜增生组、子宫内膜癌组三组在发病年龄、月经状态、孕产情况、糖尿病发病情况、肿瘤家族史、PCOS/甲减发病率、HRT/TAM使用情况之间差异无统计学意义（P＞0.05）;子宫内膜癌组的体重指数（BMI）、甘油三酯（TG）、总胆固醇（TC）、高血压发病率均高于子宫内膜正常组、增生组,差异有统计学意义（P＜0.05）;子宫内膜癌组的高密度脂蛋白（HDL）明显低于子宫内膜正常组、增生组,差异有统计学意义（P<0.05）。 结论:子宫内膜癌患者的BMI、TG、TC、HDL及高血压发病率明显高于非子宫内膜癌患者,血脂异常很可能是子宫内膜癌发生的关键因素,有望高血脂将可能作为尽早识别子宫内膜癌高危人群的预警指标。     

Coordinate expression of Cdc25B and ER-alpha is frequent in low-grade endometrioid endometrial carcinoma but uncommon in high-grade endometrioid and nonendometrioid carcinomas

Overexpression of cdc25B, an important cell cycle regulator, has been shown to result in mammary gland hyperplasia in transgenic mice and to increase steroid hormone responsiveness as a direct coactivator of the estrogen receptor (ER). We investigated the potential role of cdc25B in the pathogenesis of endometrial carcinomas in conjunction with ER-alpha. We examined the expression of cdc25B and phosphorylated ER-alpha in 4 archived human specimens of normal endometrium; 7 endometrial hyperplasia with or without atypia; 32 endometrioid endometrial carcinoma (EEC), including 20 low-grade (grade 1) and 12 high-grade (grade 2 or 3) tumors; and 18 endometrial cancers with aggressive histological subtypes (uterine papillary serous carcinoma and clear cell carcinoma, UPSC/CCC) by immunohistochemistry with monoclonal antibodies. Expression of cdc25B and phosphorylated ER-alpha was increased in endometrial hyperplasia and atypical hyperplasia compared with normal secretory endometrium. Ninety percent (18 of 20) of the low-grade EEC expressed cdc25B at a high level, whereas only 42% (5 of 12) of the high-grade EEC did so (chi(2) = 8.7; P < 0.01). Sixty-five percent (13 of 20) of the low-grade EEC expressed phosphorylated ER-alpha at high levels, but only 17% (2 of 12) of high-grade EEC did so (chi(2) = 7.0; P < 0.01). Coordinate high-level expression of phosphorylated ER-alpha and cdc25B occurred in 65% (13 of 20) of low-grade EEC but in only 17% (2 of 12) of the high-grade EEC (chi(2) = 7.0; P < 0.01). In the UPSC/CCC tumors, only 22% (4 of 18) of the tumors expressed phosphorylated ER-alpha at high-levels. However, 83% (15 of 18) of these carcinomas showed high expression of cdc25B (chi(2) = 13.5; P < 0.01). The majority of the UPSC/CCC (15 of 18) did not show coordinate high expression of phosphorylated ER-alpha and cdc25B. Our findings show that in endometrial hyperplasia and low-grade EEC, coordinate increase in cdc25B and phosphorylated ER-alpha occurs. However, in UPSC/CCC, cdc25B is highly expressed without coordinate increase in phosphorylated ER-alpha. Cdc25B may play important roles in the development and progression of EEC and UPSC/CCC by different mechanisms.     

MMP-9和Ezrin在子宫内膜癌中的表达及与ER、PR的相关性

目的检测MMP-9和Ezrin在不同类型子宫内膜中的表达情况及与雌、孕激素受体的相关性,探讨其在子宫内膜癌发生、发展中的意义。方法采用组织芯片技术及免疫组织化学方法检测和分析MMP-9和Ezrin在子宫内膜癌43例、子宫内膜不典型增生18例、单纯性增生及复杂性增生20例及正常增生期子宫内膜20例中的表达情况及与雌、孕激素受体的相关性。结果 MMP-9和Ezrin在正常增生期子宫内膜,单纯、复杂性增生,不典型增生及子宫内膜癌中的阳性率呈上升趋势,差异有统计学意义(P<0.01)。MMP-9表达强度在子宫内膜癌FIGO分期之间、浅深肌层浸润组间及有无淋巴结转移组间差异有统计学意义。Ezrin表达强度在子宫内膜癌浅深肌层浸润组间和组织类型间差异有统计学意义。MMP-9与Ezrin在子宫内膜癌上表达呈正相关(P<0.05),而Ezrin与ER在子宫内膜癌上表达呈负相关(P<0.05)。结论 MMP-9与Ezrin在子宫内膜癌的发生、浸润转移中起促进作用,Ezrin可能参与了雌激素受体阴性肿瘤的扩散和转移。     

Measurement of estrogen receptor and progesterone receptor in human endometrium and endometrial carcinoma

The concentration of cytosol estrogen receptors (ER) and progesterone receptors (PR) in the endometrium of the normal menstrual cycle and endometrial carcinoma, were measured by Enzyme Immunoassay (EIA) using monoclonal antibody, and were compared with Dextran Coated Charcoal (DCC) method. In DCC method, maximum binding sites were estimated according to Scatchard plot analysis. Following results were obtained in this study. 1) In the normal endometrium obtained from 20 cases, the correlation coefficients for ER and PR were 0.907 and 0.778, respectively. Regression lines were as follows; ER (EIA) = 1.68 (DCC) + 19.1 fmol/mg protein and PR (EIA) = 0.13 (DCC) + 24.8 fmol/mg protein. A good correlation was found between the two methods in ER assay. 2) In the normal menstrual cycle, DCC values and EIA values of ER were increased in proliferative phase, and were decreased in secretory phase. DCC values of PR were increased in proliferative phase and not decreased in secretory phase, but EIA values of PR were not remarkably changed. 3) In the endometrial carcinoma obtained from 14 cases, there was good correlation between EIA and DCC values in ER assay (r = 0.941), but correlation between the two methods was not found in PR assay. 4) In relation of histology, positive rates were highest in patients with well differentiated types, and in relation of clinical stage, positive rates were higher in the patients with early stages than progressive stages. These results suggest that EIA is as useful as DCC in ER assay in normal endometrium and endometrial carcinoma.     

Role of Morphometry and Matrix Metalloproteinase-9 Expression in Differentiating between Atypical Endometrial Hyperplasia and Low Grade Endometrial Adenocarcinoma

Background: Endometrial carcinomas are common gynecologic malignancies worldwide. In Egypt they represent2.6 %. We evaluated the role of morphometry and MMP-9 immunohistochemical expression to differentiate atypicalendometrial hyperplasia from low grade endometrial adenocarcinoma. Methods: 60 cases of endometrial lesions thatincluded 25 cases of complex endometrial hyperplasia with atypia, 25 cases of low grade endometrioid adenocarcinoma,in addition to 10 cases of proliferative endometrium as a control group. Morphometric measurements and D-scorewere evaluated. MMP9 was performed using streptavidin –biotin immunoperoxidase system. Results: D score wasmore than 1 in 100% of cases of proliferative endometrium. In atypical hyperplasia 28 % of cases had a D-score morethan 1, 44% less than 0 and 28% of cases had a D score between 0 and 1 with uncertain prognosis. All carcinomacases had D-score less than 0. MMP9 was positive in all cases of the study but differ in its degree of expression;proliferative endometrium with low expression. Atypical hyperplasia divided as 52% low expression and 48% highexpression. Most of the Endometrial adenocarcinoma cases (92%) showed high expression. There was significantdifference in expression of MMP9 in atypical endometrial hyperplasia and endometrial adenocarcinoma (p> 0.001).Conclusion: The relation between MMP9 expression and D-score value in cases of atypical endometrial hyperplasiawas highly significant P>0.001Thus, incorporating both MMP9 immunoexpression and D-score value would increasethe accuracy of diagnosis of atypical endometrial hyperplasia and low grade endometrial adenocarcinoma.     

Histogenesis of uterine corpus carcinoma--relation to atypical endometrial hyperplasia

We have studied the histogenesis of uterine corpus carcinoma with special reference to the relation to endometrial atypical hyperplasia. The summary of the results is as follows. The subjects of the study were 113 cases of operated uterine corpus cancer and 2,440 of noncorporeal (uterine) cancer. Atypical hyperplasia of the residual endometrium in corpus carcinoma was revealed in 42 of the 113 cases (37.2%). Among 19 premenopausal patients, the residual endometrium was in the secretory phase in 3 and in the proliferative phase in the others. The site of its appearance was either in the functional or non-functional layers with diffuse (16) and localized (26) types. A malignant change from the atypical hyperplastic (hormone dependent ?) and atrophic endometrium (hormone independent ?) was suggested.