Annexin A1、P16及CDK4蛋白在子宫内膜腺癌组织中的表达及其临床意义

目的:检测正常子宫内膜、子宫内膜增生症及子宫内膜腺癌组织中Annexin A1、P16及CDK4蛋白的表达,探讨其与子宫内膜腺癌发生、发展的关系。方法:应用免疫组化S-P法检测30例正常子宫内膜组织、31例单纯型增生过长、29例子宫内膜腺瘤型增生过长、32例子宫内膜不典型增生过长、66例子宫内膜腺癌组织中Annexin A1、P16及CDK4蛋白表达。结果:在正常子宫内膜(增生期)、子宫内膜增生症(单纯型增生过长、腺瘤型增生过长、不典型增生过长)、子宫内膜腺癌组织中Annexin A1(χ2=50.421,P=0.000)、P16蛋白(χ2=25.929,P=0.000)的阳性表达率依次递减,差异有统计学意义;CDK4蛋白的阳性表达率依次递增,差异有统计学意义(χ2=35.219,P=0.000)。Fisher精确概率检验显示不同肌层浸润组、不同手术病理分期、不同组织病理分级及淋巴结是否转移组的AnnexinA1、P16及CDK4蛋白的表达差异无统计学意义,而Annex-inA1阴性、P16阴性并CDK4阳性者的比例随手术病理分期、组织病理分级的升高而增加,差异有统计学意义(χ2=8.736,P=0.013,χ2=8.071,P=0.018)。Spearman等级相关分析显示Annexin A1和P16蛋白在内膜癌组织中表达呈正相关(r=0.895,P0.001);Annexin A1和CDK4蛋白在内膜癌组织中表达呈负相关(r=-0.935,P0.001);P16和CDK4蛋白在内膜癌组织中表达呈负相关(r=-0.912,P0.001)。结论:Annexin A1、P16及CDK4蛋白表达与子宫内膜腺癌的发生相关,An-nexin A1可能成为子宫内膜组织早期癌变的分子标记物。

Expressions of Annexin A1,P16 and CDK4 protein in endometrial adenocarcinoma and their clinical significances

Objective:To detect the expression levels of Annexin A1,P16 and CDK4 protein in normal endometrium,endometrial hyperplasia and endometrial carcinoma,explore their relationship with occurrence and development of endometrial adenocarcinoma.Methods:The expression levels of Annexin A1,P16 and CDK4 protein in 30 cases with normal endometrium,31 cases with simple endometrial hyperplasia,29 cases with endometrial adenomatoid hyperplasia,32 cases with atypical endometrial hyperplasia and 66 cases with endometrial adenocarcinoma were detected by immunohistochemical S-P method.Results:The positive expression rates of Annexin A1(χ2=50.421,P=0.000) and P16 protein(χ2=25.929,P=0.000) decreased gradually from normal endometrium(hyperplasia phase),endometrial hyperplasia(simple endometrial hyperplasia,endometrial adenomatoid hyperplasia and atypical endometrial hyperplasia) to endometrial adenocarcinoma,there was significant difference;the positive expression rates of CDK4 increased gradually,there was significant difference(χ2=35.219,P=0.000);there was no significant difference in expression levels of Annexin A1,P16 and CDK4 protein among different myometrium invasion depths,surgical pathological stages,histopathological grades and lymphatic metastasis or not;the proportion of cases with negative Annexin A1 and P16 and positive CDK4 increased with the increase of surgical pathological stages and histopathological grades(χ2=8.736,P=0.013,χ2=8.071,P=0.018);there was a positive correlation between Annexin A1 expression and P16 protein expression in endometrial adenocarcinoma(γ=0.895,P<0.001);but there was a negative correlation between Annexin A1 expression and CDK4 protein expression in endometrial adenocarcinoma(γ=-0.935,P<0.001),P16 protein expression was negatively correlated with CDK4 protein expression in endometrial adenocarcinoma(γ=-0.912,P<0.001).Conclusion:The expression levels of Annexin A1,P16 and CDK4 protein are related to the occurrence of endometrial adenocarcinoma,Annexin A1 may become a molecular marker of early canceration of endometrium.