p16、Cyclin D1和COX-2蛋白在子宫内膜不同增生性病变中的表达及意义

 目的 探讨p16、Cyclin D1及COX-2蛋白在子宫内膜的癌前病变及子宫内膜样腺癌中的诊断价值。 方法 采用免疫组织化学SP法，对131例不同增生性子宫内膜病变组织中p16、Cyclin D1及COX-2蛋白 的表达进行检测，并对子宫内膜样腺癌发病新模式的不同阶段3种蛋白的表达进行对比观察。 结果 （1）根据EIN组织学诊断及分类标准，在94例子宫内膜增生病例中共检出EIN病例26例，其余 68例为良性子宫内膜增生病例。（2）p16和Cyclin D1蛋白在增殖期子宫内膜、良性子宫内膜 增生、EIN及子宫内膜样腺癌4组中的阳性表达率及高表达率均无明显差异（ P 均>0.05）。（ 3）COX-2蛋白在正常增殖期子宫内膜组织中不表达；在EIN和子宫内膜样腺癌组阳性表达率及 高表达率均分别显著高于增殖期子宫内膜和良性子宫内膜增生组（ P 均<0.01），而两组间在 阳性表达率和高表达率上均无明显差异（ P 均>0.05）。 结论 与p16、Cyclin D1蛋白表达相比，COX-2 蛋白的高表达在子宫内膜样腺癌的发生过程中可能是 一种早期分子事件。其表达在鉴别良性子宫内膜增生和EIN、子宫内膜样腺癌方面可能是一种 有用的肿瘤性标志物。

Expression and Significance of p16, Cyclin DI and COX-2 Protein in Various Hyperplastic Lesions of Endometrium

Objective To detect the expressions of p16, Cyclin D1, COX-2 protein in various hyperplastic lesions of endometrium and explore the potentiality of these proteins as markers in diagnosis of EIN and endometrioid adenocarcinoma. Methods Expression of p16, Cyclin D1,COX-2 protein was detected in 131 cases of various hyperplastic endometrial lesions by immunohistochemistry and analyzed by statistics. Results (1) 26 EIN and 68 benign hyperplasia were rediagnosed in 94 endometrial hyperplasia. (2) There was no significant differences in positive expression and overexpression rate of p16 and Cyclin D1 among proliferative endometrium , benign hyperplasia, EIN and endometrioid adenocarcinoma ( P >0.05). (3) Positive expression and overexpression rate of COX-2 in EIN and endometrioid adenocarcinoma was significantly higher than those in proliferative endometrium and benign hyperplasia( P <0.01)，but difference was not obvious in EINand endometrioidadenocarcinoma（ P >0.05）. Conclusion In contrast to expression of p16 and Cyclin D1, overexpression of COX-2 may be an early event in the tumorigenesis for endomerioid adenocarcinoma;andthis protein was useful tumor markers in distinguishing benign hyperplasia from EIN and endometrioid adenocarcinoma.