PTEN和CyclinA蛋白在子宫内膜癌组织中的表达及临床意义

目的：探讨PTEN和CyclinA在子宫内膜癌中的表达及其在癌发生发展中的作用。方法：采用免疫组化SP法检测PTEN和CyclinA蛋白在30例正常子宫内膜、30例子宫内膜增生、20例子宫内膜不典型性增生、55例子宫内膜癌组织中的表达。结果：不典型增生组和子宫内膜癌组中PTEN阳性表达率分别为55．00％（11／20）、45．45％（25／55），与全部为阳性表达的正常内膜及阳性表达率为90．00％（27／30）的子宫内膜增生组比较，不典型增生组和癌组中PTEN阳性表达均显著低于正常子宫内膜和子宫内膜增生组（P〈0．05）。CyclinA在不典型增生组和癌组中阳性表达率分别为45．00％（9／20）、67．27％（37／55），显著高于全部阴性表达的正常子宫内膜组和子宫内膜增生组（10．00％，3／30）（P〈0．05）。两者在不典型增生和子宫内膜癌组中的表达均呈显著性负相关（r=-0．5330，r=-0．5556；P〈0．001）。癌组中PTEN阳性表达的缺失与组织学分级有关（P〈0．05），但与肿瘤的浸润转移、临床分期和复发无关（P〉0．05）；CyclinA的阳性表达率与组织学分级、肿瘤的浸润转移和临床分期、复发有关。结论：PTEN表达缺失和CyclinA的过度表达涉及子宫内膜癌的发生、发展过程，二者联合检测可作为子宫内膜癌早期诊断、判断肿瘤生物学行为的免疫学指标。

Expression of PTEN and CyclinA protein in endometrial carcinoma and clinical significance

Objective:To evaluate the significance of PTEN and CyclinA proteins and the correlations with carcinogenesis and tumor progression in endometrial carcinoma.Methods:The expression of PTEN and CyclinA was detected by immunohistochemical staining S-P method in 30 cases of normal endometrium,30 cases of endometrial hyperplasia,20 cases of atypical hyperplasia of endometrium and 55 cases endometrial carcinoma.Results:All the normal endometriums showed positive staining of PTEN.The positive expression rates of PTEN in endometrial hyperplasia,atypical hyperplasia of endometrium and endometrial carcinoma were 90.00%(27/30),55.55%(11/20),45.45%(25/55),respectively.The expression of PTEN in atypical hyperplasia of endometrium and endometrial carcinoma was significantly lower than that of normal endometrium and endometrial hyperplasia(P<0.02).The positive rates of CyclinA protein in endometrial hyperplasia,atypical hyperplasia of endometrium and endometrium carcinoma were 10.00%(3/30),45.00%(9/20),67.27%(37/55),respectively.No positive staining was detected in normal endometriums.The expression of CyclinA in atypical hyperplasia of endometrium and endometrium carcinoma was significantly higher than those of normal endometrium and endometrial hyperplasia(P<0.02).The expression of PTEN protein was inversely correlated with CyclinA in atypical hyperplasia of endometrium and endometrium carcinoma(r=-0.5330,r=-0.5556;P<0.001).In endometrium carcinoma the expression loss of PTEN protein was significantly associated with histological grade,but not related to muscle invasion,clinical stage and recurrence.The expression of CyclinA protein was significantly correlated with histological grade and muscle invasion and clinical stage and recurrence.Conclusion:The loss expression of PTEN and the overexpression of CyclinA protein are closely related to the development and recurrence of endometrial carcinoma.Combined detection of PTEN,CyclinA might be useful in the early diagnosis,predicting the biological behavior and prognosis of endometrial carcinoma.