子宫内膜癌患者血清及病理分子标志物与其病理特征关系的研究

目的探讨子宫内膜癌组织中癌基因表达及血清学肿瘤标志物水平与其临床病理特点及预后的相关性。方法回顾性分析467例原发性子宫内膜癌患者的临床病理资料。并按照临床预后的高危因素将子宫内膜癌患者分为高危组和低危组。采用免疫组化法检测其组织中雌激素受体（ER）、孕激素受体（PR）、PTEN、p53和Ki-67基因的表达,电化学发光法和酶联免疫法检测血清中CA125、CP2、CA199及唾液酸（SA）等肿瘤标志物,分析各项肿瘤标志物与其临床病理特征的相关性。结果不同临床病理分期ER、PR、PTEN、CA125和CP2表达比较,差异均有统计学意义（P〈0.05）,不同病理分级ER、PR、Ki-67和SA表达比较,差异有统计学意义（P〈0.05）,不同肌层浸润深度PR、CA125和CA199表达比较,差异均有统计学意义（P〈0.01）,有无淋巴结转移ER、PR、CA125和CP2表达比较,差异均有统计学意义（P〈0.01）,有无脉管内癌栓CA125和SA表达比较,差异有统计学意义（P〈0.05）,有无腹水癌细胞CA125表达比较,差异有统计学意义（P〈0.001）。高危组PR表达显著低于低危组（P〈0.05）,高危组Ki-67、CA125、CA199和CP2的表达均显著高于低危组（P〈0.05）,两组中ER、p53、PTEN和SA表达比较,差异均无统计学意义（P〉0.05）。结论 PR、Ki-67、CA125、CA199和CP2与子宫内膜癌的预后密切相关,有助于指导临床治疗。

Study of molecular markers in patients with endometrial carcinoma and its prognosis on the effectiveness

Objective To investigate the relationship between the expression of oncogene and cancer suppressor gene in the cancer tissue and the serum tumor markers with the clinic characters and the prognostic value of endometrial carcinoma.Methods 467 cases of endometrial cancer with complete data in the Peking University Peoples Hospital from Jan.1995 to Dec.2009 were enrolled.The tumor markers in the serum（CA125,CP2,CA199 and SA）and the expression of ER,PR,PTEN,p53 and Ki-67 in cancer tissues were detected.The correlation between the molecular markers and its clinical pathological characteristics and risk factors was analyzed.Results The expression of ER,PR,CA125,CP2 and PTEN was significantly different among the patients with different clinical pathological staging（P〈0.05）.The expression of ER,PR,Ki-67 and SA was significantly different among that with different pathological classification（P〈0.05）.The expression of PR,CA125 and CA199was significantly different among the patients with different depth of myometrial invasion（P〈0.05）.The expression of ER,PR,CA125 and CP2was significantly different between the patients with or without lymph node metastasis（P〈0.05）.The expression of CA125 and SA was significantly different between that with or without tumor thrombus in pulse tube（P〈0.05）.The expression of CA125 was significantly different between that with or without ascites tumor cells（P〈0.05）.The expression of PR in high risk group was significantly lower than that in low risk group（P〈0.05）.The expression of Ki-67,CA125,CA199 and CP2were significantly higher in high risk group than that in low risk group（P〈0.05）.There was no significantly different expression of ER,p53,PTEN and SA in two groups（P〉0.05）. Conclusions The expresion of PR, Ki-67,CA125,CA199 and CP2 were closely related to the prognosis of endometrial cancer.